HomeMy WebLinkAboutHO201300072 Legacy Document 2013-05-06FOR OFFICE USE ONLY ITO # - r<
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Application for � Y°1l:
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Class A Home Occupation Clearance rn.,n,�
❑ Home Occupation Class A Clearance = $25.00
❑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.
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Name of Business: ha K SZ—
Type of Business: (1,1�I 1(AC.LIL—�
Tax map and parcel: I � - qA Zoning:
Contact Person (Who should we call/write concerning this project?): '-pa-N1
Address2o?)°i V1 A �- 00en C e QCT city (-�(xG�n V i I P{ State (�_ Zip . 1
Daytime Phone qN 01n q3) S? Fax # E-mail
Owner of Record p(AJA2 _afYle<;nQ 1t , /
Address cqf)2 � I q eO m nCP � City #600-P_ state V A zipapqji_
Daytime Phone W 9l) W , )1' n Fax # ( ) E-mail
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
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)]
E. 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)]
Z- ALES
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
ZTRAFFIC
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)]
�DIPARKING
All vehicles used in a home occupation and all vehicles of customers, clients or students shall be parked on-site.
[Section 5.2 (f)]
PERFORMANCE STANDARDS
The home occupation shall comply with the performance standards in section 4.14. [Section 5.2A (k)]
Does the use involve procedures, machinery or chemicals that may cause the following's
YES NO
NOISE
VIBRATION
GLARE
BEAT
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).
aPROHIBITED 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 5.11
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. I also certify that I have read the restrictions on Home Occupations, that I understand them, and that I will abide
them.
���3%/3
ate
Signu of wner/Applicant Date
N 9 g9 �/ g
Print 1 e Daytime phone number of Signatory
Re iewer /Date
ENGINEER'S REPORT ATTACHED: YES NO h/
7/1/2011 Page2of2
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompanyzoning applications (home Occupation, Zoning Clearance, Z�icing
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the applica ion is not the
owner.
I certif`Xthat notice of the application,
[County application name,and number]
1
i
was provided to the o -ner of record of Tax Map
[name(, f the record owners of the parcel] i
and Parcel Number by deliver'mg a copy of the application in the
manner identified below:
Hand delivering a copy of\icati.oyn,///
ame o fthe record owner if the record owner is a
person; if the owner of recfy the recipient of the record and the recipient's
title or office for that entit
on
Date
Mailing a copy of the application to
if the owner of record is an entity, iI
office for that entity]
on
Date
.e of the rec rd owner if the record owner is a person;
the recipient bf the record and the recipient's title or
to the following
[address; written notice ailed to the .owner at the last known address f the owner as shown on
the current real estate ax assessment books or current real estate tax ass sment records satisfies
this requirement].
Signature of Applicant
Print Applicant Name
Date