HomeMy WebLinkAboutHO201500187 Application 2015-09-09Envelope ID: 2515DO22-441D-4151-SE8A-15785989AOB
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Application for
Class A Home Occupation Clearance is
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 a hcant
Home Occupation, Class A: An occupation, not expressly prohibited by section 52, 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 Baseness•s`j Ons ^ _
Type of Business: 0VA Il' ' 1
Tax map and parcel:
Contact Person (Who should we callAvvrite wncernmgthis pr j�eW)=,{�(S�vLLL[L(L1 �y{ - f , i l ps
Address 1914 _ V2 N , Vi—If 4 Vl 1 ! 1 fond V 9 City V�U w �:] �1 4 l & State � Zip un 0
Daytime Phone Al 63 yo 0 1-33V Fax # c--)
E-mail .fi 0 A M0A I
ownerotRecord 001 Edm 0 nd yup W n J _.
Address ±��_ /�,St l I�Y1 V ... city l�?2 state 1/ zip 2 2q 3
Daytime Phone t ` 1 ✓ �'� i L33 '1 Fax # (_) E-mail th4AU� S C C0 MCC . it
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:
UNDERSTAND THE RE UIRENW-M 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)]
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)]
4SALES
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) 9724126
DocuSign Envelope !D: 251 5DO22-441 D-4151-9E8A-1 5785989AOBD
R(TRAMC
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)]
NJ PAKKMG
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 %Dowing?
NOISE
VIBRATION
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
RADIOACTIVITY
ELECTRICAL DISTURBANCE
NON-DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER
YES NO
A
X
�C
Ii 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 52 (h)]
..a: .
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 51]
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.
D.MBlgmd by.
9/9/2015
,of.Owner/Applicant 1raie
Roy E Gupton 7r 434-981-2337
Print e
fewer
ENGINEER'S REPORT ATTACHED: YES NO
CONDITIONS:
Daytime phone number of Signatory
Date
Docu5ign Envelope 1D: 2515DO22-441 D-4151.9E8A-15785989AOBD
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
AdministratorDe&vn inaiions or Appeals, Sign Permits, Bnadiag Permits) if the application is not the
owner.
I certify that notice of the application, UMSA-iA MUChAvemon i e fan uj
[County application game and number]
was provided to CS
UV.S the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 1- 0 Q - p by delivering a copy of the application in the
manner identified below:
J Hand delivering a copy of the application to n Sr
[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]
on 01�_iP 15-
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]
on
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 current real estate tax assessment records satisfies
this requirement].
v�
Signa of Applicant
`.�ov jo `1 j ce,
Print Applicant Name
11611
Date