HomeMy WebLinkAboutHO201300036 Legacy Document 2013-03-05FOR OFFICE USEONLY HO # D
Fee Amount $ Date Pai7d By who? � � Ck# +V By:
� Oti A1.Iu,,i
Application for al
Class A Nome Occupation Clearance
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[/home Occupation Class A Clearance = $25.00
F-1 Certification that notice of this application has been provided to the property owner, if owner is different
from applicant
Home Occupation, Class A: An occupation, not expressly prohibited by section 5.2, conducted for profit within a dwelling
unit solely by one or more members of the family residing within the dwelling unit; provided that nothing herein prohibits the
occupation from engaging other persons who work off-site and do not come to the dwelling unit to engage in the occupation.
Name of Business:
Type of Business:
Tax map and parcel:
A1'�'C�1'071 t, 4
Z�i R�SCor�2
Zoning:
Contact Person (Who should we call/write concerning this project?):
)/
Address '550 / ���� �Od`'' / t !f City �/"O fi /Sta/te 11A Zip 22 3 Z
Daytime Phone �✓- 3I 7c3'2- Fax # L—) E-mail 1'7-7e, (/ �Co7� CaS� Iii e
Owner of Record / " ' �/ co
Address �%`M e City
Daytime Phone U Fax #
E-mail
State Zip
This certificate, in conjunction with a business license, represents zoning approval to conduct the Class A Home Occupation
identified above. Each home occupation is subject to the following:
PLEASE CHECK EACH BOX SO THAT IT IS CLEAR THAT YOU HAVE READ AND
UNDERSTAND THE REQUIREMENTS FOR THIS CLEARANCE
LJ LOCATION & AREA
The home occupation shall be conducted entirely within the dwelling unit, provided that not more than twenty-five
(25) percent of the gross floor area of the dwelling unit shall be used for the home occupation and further provided
that the gross floor area used for the home occupation shall not exceed one thousand five hundred (1500) square feet.
[Section 5.2 (b) 1)]
EXTERIOR APPEARANCE
There shall be no change in the exterior appearance of a dwelling unit or other visible evidence of the conduct of a
home occupation. [Section 5.2 (c) 1)]
/SALES
No home occupation shall sell goods to a customer who comes to the site except for goods that are hand-crafted on-
site and goods sold that are directly related to a beauty shop or a one -chair barber shop home occupation.
[Section 5.2 (d)]
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
7/1/2011 Page 1 of
E2 TRAFFIC
The traffic generated by a home occupation shall not exceed the volume that would normally be expected by a
dwelling unit in a residential neighborhood. [Section 5.2 (e)]
L! PARKING
All vehicles used in a home occupation and all vehicles of customers, clients or students shall be parked on-site.
[Section 5.2 (f)]
701
PERFORMANCE STANDARDS
The home occupation shall comply with the performance standards in section 4.14. [Section 5.2A (k)]
Does the use involve prOCedureS7 machinery Or chemicals that may cause the following?
NOISE
VIBRATION
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
RADIOACTIVITY
ELECTRICAL DISTURBANCE
NON-DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER
If YES, then applicable standards must be addressed with a Certified Engineer's Report (available from staff).
PROHIBITED USES
The following uses are expressly prohibited as home occupations: (1) tourist lodging; (2) nursing homes; (3) nursery
schools; (4) day care centers; and (5) private schools. [Section 5.2 (h)]
WAIVERS AND MODIFICATIONS: The above standards are eligible for waiver or modification by the Planning
Commission. Ask staff for more information about applicable fees and process. [Section 35 and Section 5.1]
Owner/Applicant Must Read and Sign
I hereby apply for approval to conduct the Home Occupation identified above, and certify that this address is my legal
residence.y also certify that I have read the restrictions on Home Occupations, that I understand them, and that I will abide
by them
2 -y -13
__3
Owner/
Date
Print Nal Daytime phone number of Signatory
Reviewer Date
ENGINEER'S REPORT ATTACHED: YES NO
7/1/2011 Page 2 oN
CERTIFICATION THAT NO CE OF THE
APPLICA ON HAS BEEN PROVIDE TO THE LANDOWNER
This form must acc pany zoning applications (Home Occu ation, Zoning Clearance, Zoning
Administrator Detern inations or Appeals, Sign Permits, Bu fling Permits) if the application is not the
owner.
I certify that notic of the application,
ounty application name and number]
was provided to the owner of record of Tax Map
[name(s) of le record owners of t e parcel]
and Parcel Number by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of\thapplicati n to[Name of the record owner if the record owner is a
person; if the owner of recan e ity, identify the recipient of the record and the recipient's
title or office for that entity
on
Date
Mailing a copy of the applicatio to
[ me of the record owner if the record owner is a person;
if the owner of record is an ent' y, identi the recipient of the record and the recipient's title or
office for that entity]
on to the ollowing address:
Date
[address; written notice ailed to the owner at th last known address of the owner as shown on
the current real estate to assessment books or curr nt real estate tax assessment records satisfies
this requirement].
Signatu e of Applicant
Print Apph ant Name
Date