HomeMy WebLinkAboutHO201200121 Legacy Document 2012-06-19FOR OFFICE USE ONLY HO # G 1
Fee Amount $ `5 DO Date Paid p 1& 1Z By who? Cl D dit � RE -14, �teceipt # 5 7 lV Ck# � By: rV Y�
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:
Type of Business: C.,tj-k�
gl�y� rr�%ann psi 1�2U�1�Pc
Tax map and parcel: 1� 1 ` i) Zoning: � ti
Contact Person (Who should we call/write concerning this project?): A NNPAR'ZTN k
Address \e\-kD TA ?NNAI�a_% Mds CityC %!J3 ,%-MT-_44ML1.R_ State _Zip ZZ0\\
Daytime Phone t4_� °ll�l-O 516 Fax # E-mail V\cidtk qax Q Gtr �\
• Cpm
Owner of Record (3-
Address
r
Address 15;%, — City
Daytime Phone C___)
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 hone occupation is subject to the following:
PLEASE CHECK EACH BOX SO THAT IT IS CLEAR THAT YOU HAVE READ AND
91
UNDERSTAND THE REOUIREMENTS FOR THIS CLEARANCE
L� 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)]
Ll 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)]
B'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 I of
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)]
21PARKING
All vehicles used in a home occupation and all vehicles of customers, clients or students shall be parked on-site.
[Section 5.2 (01
.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
If YES, then applicable standards must be addressed with a Certified Engineer's Report (available from staff).
91PROHIBITED 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
by them.
\ �Z
Signatu\N of Owner/Applicant Date
t_zN-bg" �At�'Z�sNCr
Print me
R rWer /
NO V
ENGINEER'S REPORT ATTACHED: YES
CONDITIONS:
\V3V - glaz-051 1p
Daytime phone number of Signatory
Date
7/1/2011 Page 2 of 2
J
i
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
Thus forst must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Deterntinationts or Appeals, Sign Permits, Building Pe rn its) if the application is not the
owner.
T certify that
was provided to
[name(s)
and Parcel Number
manner identified below:
of the application,
[County,dpplication name and number]
/ the owner of record of Tax Map
record owners of the 7by
11
delivering a copy of the application in the
Hand delivering a copy of the
person; if the owner of record is
title or office for that entity]
/ [Name of the record owner if the record owner is a
identify the recipient of the record and the recipient's
on i
Date
Mailing a copy of the app/tity,
[Name o
if the owner of record is aentify the
office for that entity]
on to the fi
Date
[address; written
the current real es
this requirement].
record owner if the record owner is a person;
ipient of the record and the recipient's title or
address:
,e mailed to the owner at the last knoOaddress of the owner as shown on
tax assessment books or current real este tax assessment records satisfies
Signature of Applicant
Print Applicant Name
Date