HomeMy WebLinkAboutHO201600067 Application 2016-03-17FOR OFFICE USE ONLY
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Fee Amount $ Z Date Paid -�1� By who? Receipt #i Ckli
'��By-Z4!!K_
Application for
Class -A Home Occupation Clearance
Home Occupation Class A CIearance = $27.00
Home Occupation, Class A: An occupation, not expressly prohibited by section 5.2, conducted for profit within a dwelling
ts th
unit solely by one or more members of the family residing within the dwelling unit; provided that nothing herein prohibie
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: (] U cq /45So r_.ict}� 5 , L i- C
Type of Business:
Tax map and parcel: -� -�/�M2120 Zoning:
Contact Person (Who should we call/write concerning this project?):
Address �jc l� City I:r [ State UP Zip ;Z2V l
Daytime Phone
Owner of Record
Fax # L)
Address S Z Ttif,, City S4 a ixt42 State UA Zip Aa_ 9
Daytime Phone Fax # (�� E-mail y�
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
ANn If TNnlr♦ 1D Q -r A ern rririm
W 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)]
ff-EXTERIOR APPKARANCE
There shall be no change in the exterior appearance of a dwelling unit or other visible evidence of the conduct of a
hom ccupation. [Section 5.2 (c) 1)]
7
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) 9724126
11/1!21115 Page 1 oft
S TRAFFIC
The traffic generated by a home occupation shall not exceed the volume that would normally be expected by a
d Ing 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.
[Sec ' a 5.2 (1))
PERFORMANCE STANDARD,
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?
YES NO
NOISE
VIBRATION
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
RADIOACTIVITY
ELECTRICAL DISTURBANCE
NON-DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER
ZIf S, then applicable standards must be addressed with a Certifled 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 5.11
Owner/Applicant Must Read and Sign
I hereby apply for a oval t uct th Home Occupation identified above, and certify that this address is my legal
residence. I also rtify th ve read a restrictions on Home Occupations, that I der d them, and that I will abide
by them.
Signature of wner A licant Date
6
Print N Daytime one num er of Signatory
/�
Reviewer Date
ENGINEER'S REPORT ATTACHED: YES NO
CONDITIONS:
1111!1015 Page 2 &2
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CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, �% f.� 1{�p11�dc L# enz
[County applica on name and number]
was provided to r the owner of record of Tax Map
[nLn s) of the record owners f the parcel]
and Parcel Number 06S -V 6 -d
manner identified below: 0r3, by delivering a copy of the application in the
_ Hand delivering a copy of the application to �t�re�cord
[Name of the record owner iwner 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 3 G
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 ofthowner as shown on
the current real estate tax assessment books or current real estate t sess encords satisfies
this requirement]. 1.107
of
Print Applicant Name
Date