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C,,IAApplication forClass A Horne Occupation Clearance
I_Iomc Occupation Class A Clearance = $2.5.00
!-tome Occupation, laassif: An occupation, not expressly prohibited by section 5.2, Conducted for profit within a dwelling
unit solely by 011e or More 111Ci11bers of the family residing Wit'hill the dWCl1ing unit; provided that nothing herein 1)rollibits the.
OCCIII)a6011 fl'0111 Crlgitging other Im-sons who work off-site and Clo 1101. conte to the dwelling lillit to CilgitgC ill the OCCCIINIJ011.
Name of Business;
Type of Business;
Tax map and pare(
_............ ---
Contact Person (Who should we call/wipe concerning this proicct?):
Address X 93 1.Q/d _ City C4.4e1__b�1 , l(z1 _— State —Zip ZZ D�
Daytime Phone (.�i��._� � C9 Fax t! (—) _ � E-mail nAwf� f�-��.• ��_.'�? `� ��L-`C�lil
�+ S
Owner of Record �CJ j_(;(, — C'1 ! a___
Address
Daytime Phone
Fax # (__)
E-mail
State Zip
This certificate. in conjunction with a business license, represents zoning approval to conduct the Class A I tome Occupation
identified above. EIdl 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
1�1 LOCATION & AREA
The home occupation shall be ConduCted entirely NA'ithin the dwelling unit, provided that not more than twenty-five
(25) percent of the gross floor arca 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
honle occupation. [Section 5.2 (c) 1)]
ZSALES
No honk 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 direct])' 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
2/1/2011 Pape I or2
TRAFFIC
The; traffic generated by a home oocupation shall not exceed the volume that would normally be expected by a
dwelling unit in a residential neighborhood. [Section 5.2 (e)]
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)]
PERFORMANCE STANDARDS
'1'hc hollle occupation shall collll)ly with the perlornialice standards 111 section 4.14. ISection 5,2A (k)]
Does the use involve procedures machinery or chemicals that mai, cause the following;?
NOISE
VIBRATION
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
RADIOACTIVITY
ELECTRICAL DISTURBANCE
NON-DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER
-- 7'
I'f''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, I also certify that I have read the restrictions on Home Occupations, that I understand them, and that I will abide
by
Signature of Owner/Applicant Date
Print Name
�lewer
ENGINEER'S REPORT A'T'TACHED; YES NO
70 ���_
Daytime phone number of Signatory
711 6,a
Date
CONDITIONS;
2/1/2011 Pnge2or2
a -. , P,
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form nncst accompany zoning applications (Home Occupation, Zoning Cleat,ance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
[County ap lication name and number]
was provided to %wN,-,tl'P C&&/; w the owner of record of Tax Map
[narne(s) of the record owners of the parcel]
and Parcel Number � ICU -2- — ,jam l�, by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
Oil
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
Oil
Date
to the following address:
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or cur•ent.real estate tax assessment records satisfies
this requirement].
re of Applicant
Print Applicant Name
zgZ ZZ, l,?
Date .
COMMONWEALTH of VIRGINIA
In Cooperation with the
State Department of Health
Phone(434)972-6219
Fax (434) 972-4310
Mr. Rafael Maldonado
293 Albert Ct
Charlottesville Va. 22901
Thomas Jefferson Health District
1138 Rose Hill Drive
P. O. Box 7546
Charlottesville, Virginia 22906
July 10, 2013
Re: Plan review APPROVAL for proposed mobile food truck Tacos Don Panchito
Dear: Mr. Maldonado
ALBEMARLE- CHARLOTTESVILLE
FLUVANNA COUNTY (PALMYRA)
GREENE COUNTY (STANARDSVILLE)
LOUISA COUNTY(LOUISA)
NELSON COUNTY (LOVINGSTON)
The plans for your facility have been reviewed for compliance of the Virginia Department of
Health- Food Regulations. The plans have been approved. If the proposed use and/or menu for
this facility change in any way after approval, you will need to notify the department to ensure
adequacy of the equipment and facility.
Schedule an inspection once all the food is in place 2 to 3 days prior to opening at which point
your annual permit to operate will be issued once substantial compliance with the Virginia Food
Regulations (12 VAC 5-421) is observed. If you have any questions pertaining to this matter or
wish to schedule an inspection, please call (434) 972-4311
Si ly,
Jason Fulton
Environmental Health Specialist Sr.
Cc: Eric Myers, Supervisor
File
COMMONWEALTH of VIRGINIA
In Cooperation with the
State Department of Health
Phone (434) 972-6219
Fax (434) 972-4310
_ --- -Mr. Rafaol-Maldonado -
293 Albert Ct
Charlottesville Va. 22901
Thomas Jefferson Health District
1138 Rose Hill Drive
P. O. Box 7546
Charlottesville, Virginia 22906
July 10, 2013
Re: Plan review APPROVAL for proposed mobile food truck Tacos Don Panchito
Dear: Mr. Maldonado
ALBEMARLE- CHARLOTTESVILLE
FLUIVANNA COUNTY (PALMYRA)
GREENE COUNTY (STANARDSVILLE)
LOUISA COUNTY(LOUISA)
NELSON COUNTY (LOVINGSTON)
The plans for your facility have been reviewed for compliance of the Virginia Department of
Health- Food Regulations. The plans have been approved. If the proposed use and/or menu for
this facility change in any way after approval, you will need to notify the department to ensure
adequacy of the equipment and facility.
Schedule an inspection once all the food is in place 2 to 3 days prior to opening at which point
your annual permit to operate will be issued once substantial compliance with the Virginia Food
Regulations (12 VAC 5-421) is observed. if you have any questions pertaining to this matter or
wish to schedule an inspection, please call (434) 972-4311
Si ly,
Jason Fulton
Environmental Health Specialist Sr.
Cc: Eric Myers, Supervisor
File