HomeMy WebLinkAboutHO201500004 Legacy Document 2015-01-15FOR OFFICE USE ONLY AO #
Fee Amount ho Date Paid By who. Receipt # _%At;2i Ckil h B .
Application for
Class A Home Occupation Clearance
❑ 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.
Name of Business: pr t° J�('� nca �, L� LLL
Type of Business: E { �t'� /' ir` z rRi t
Tax map and parcel:�d-6'°�-- Zoning: KID-
-'
Contact Person (Who should we call/write concerning this project?); , a rr�ii S ) i � ankers le
Address 1 a �I n �t ;I) 0ov� City (._, Af lr'"I"�"i State ,� Zip v p
Daytime Phone ( f1 t% b q j 3 Fax # U E-mail T��► ��rs ��ti L� �rl�S �i 9.n �, I
Owner of Record C h., fit/ A k r tt`�� )% ! `n r
Address ))Q � &r S - 111 Y„�f+'� "+ City �``alf/a�- Sem'"{ State I//� Zip %U
Daytime Phone old 4 3 LI Fax # L� E-mail +r kB / 5 haw c-��o�s �'�^� �• toy.
This certificate, in conjunction with a business license, represents zoning approval to conduct the Class A Horne 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 REOUIREMENTS 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 (15 00) square feet.
[Section 5.2 (b) 1)]
2(E 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)]
2/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/l/201 1 Page I of 2
LJ 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)]
Lit' PARKING
A]I vehicles used in a home occupation and all vehicles of customers, clients or students shall be parked on-site.
,.,[Section 5.2 (f)]
I.9 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?
NOISE
VIBRATION
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
RADIOACTIVITY
ELECTRICAL DISTURBANCE
NON-DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER
YES NO
x
7/
S-1/
_C
X/
IIf YES, then applicable standards must be addressed with a Certified Engineer's Report (available from staff).
LJ 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 t at I h read the restrictions on Home Occupations, that I understand them, and that I will abide
by them.
Signature of Owner/Applint Date
C � a r L5
Print Name
R ' wer
ENGINEER'S REPORT ATTACHED: YES NO
CONDITIONS:
)C) � �a6 y330
Daytime phone number of Signatory
/"/s
Date
7/1/2011 Page2of2
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany toning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner. J
I certify that notice of the application;
was provid
[County application na e and number]
the wrierof record of Tax Map
of the record owners of the parcel]
and Parcel Number by dell
manner identified below:
Hand delivering a copy of the a�pp
person; if the owner of record is an
title or office for that entity]
on
Date
Mailing a copy of the application to
if the owner of record is an entity, is
office for that entity]
on
Date
[address; written notice
the current real estate to
this requirement].
a copy of the application in the
to
[Name of e record owner if the record owner is a
identifv the ecipient of the record and the recipient's
e of the record
the recipient of
to the following address:
if the record owner is a person;
cord and the recipient's title or
to the owner at the last known address of tNoect
wner as shown on
sment books or current real estate tax assesrecords satisfies
Signature of Applicant
Print Applicant Name
Date