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Home My WebLink AboutHO201700357 Application 2017-09-13FOR OFFICE USE ONLY HO # ' Fee Amount $4) Date Paid _�_r�'_� By who? �1(�k Receipt # L"3__Ck#]301 y ` t — By:_ dM Application for . Class A Home Occupation Clearance ., ❑ Home Occupation Class A Clearance = $27.00 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: Tax map and parcel: Zoning: Contact Person (Who should we call/write concerning this project`?): R1104 gA�ft Address , � � �C\ LaV_QCity �Vr i `\VL State \% 1r Zip C x l_ a3 Daytime Phone Z LQ—)�t_(� p Fax # ) E-mail niCv\e 11Qa% � I �'' q rY,l (, `. ny" Owner of Record 1141 c Ili. 6 r �/' 11 7A . Address City State Zip Daytime Phone (__) Fax # U E-mail 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 AND UNDERSTAND THE REQUIREMENTS 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)] E(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)] '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 11/1/2015 Page I of2 TRAFFIC The traffic generated by a home occupation shall not exceed the volume that would normally be expected by a welling 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 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 V WATER POLLUTION ✓ RADIOACTIVITY ✓ ELECTRICAL DISTURBANCE NON -DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER If 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 5.11 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. Signature of Owner/Applicant Print Na J., _f A— Revie er ENGINEER'S REPORT ATTACHED: YES NO 1./ CONDITIONS: , . q-12-zon Date — su,�; z Daytime phone number of Signatory ylra I I � Date 11/1/2015 Page 2 of2 INSTRUMENT # 201700000398 RECORDED ALBEMARLE CO CIRCUIT COURT CLERK'S OFFICE Sep 08, 2017 AT 11:21 am JON R. ZUG, CLERK by EMJ CERTIFICATE OF ASSUMED OR FICTITIOUS NAME BOOK 00028 PAGE 0430 - 00430 Commonwealth of Virginia This is to certify that the below named person, partnership, limited liability company or corporation intends to conduct or transact business under an assumed or fictitious name in the [ ] City [ Ifcounty of . .................... . 1. The ASSUMED OR FICTITIOUS NAME of business L� V:; � 2 .... �eOAA-41... �?► .....11J .l\ vJ"3!........................................................................................ 2. The above business is owned by the following entity type: [ ] SOLE PROPRIETORSHIP (Complete A below) [ ] PARTSHIP (Complete B below) fa MITED LIABILITY COMPANY (Complete C below) [ CORPORATION (Complete C below). A. NAME OF OWNER.............................................................................................................................................................. RESIDENCEADDRESS...................................................................................................................................................... POSTOFFICE ADDRESS................................................................................................................................................... B. NAME OF PARTNERSHIP................................................................................................................................................. OFFICEADDRESS.............................................................................................................................................................. POSTOFFICE ADDRESS................................................................................................................................................... (1) Is this a general partnership? [ ] NO [ ] YES. If YES, complete the Statement of Partners on Page Two of Two. (2) Is this a domestic limited partnership? [ ] NO [ ] YES. If YES, a certified copy of this certificate must be filed with the State Corporation Commission. Va. Code § 59.1-70. (3) Is this a foreign limited partnership? [ ] NO [ ] YES. If YES, indicate the date of the certificate of registration to transact business in the Commonwealth of Virginia issued by the State Corporation Comm*ssio.................................................. A certifie copy of this certificate must be filed with the State Corporation Commission. Va. Code § 59.1-70. C. NAME OF [ CORPORATION [ ] LIMITED LIABILITY COMPANY ....�.......`s�..�:�'S?:�................. ....... 5.................................................................. OFFICE ADDRESS ..� .. ��0 } � .......L Ci��L ....�� . ....V VY4 .. sz-gC?.ti�........ POSTOFFICE ADDRESS................................................................................................................................................. (1) A corporation or limited liability company must file a certified copy of this certificate with the State Corporation Commission. Va. Code § 59.1-70. (2) Is this a foreign corporation or a foreign limited liability company? [l k1W [ ] YES. If YES, indicate the date of the certificate of authority/registration to transact business in the Commonwealth of Virginia issued by the State Corporation Commission: .......................................... ACKNOWLEDGMENT I certify that the foregoing is true and correct to the best of my knowledge and belief. SoleProprietorship................................................................................. NAME OF OWNER SIGNATURE OF OWNER Partnership NAME OF GENERAL PARTNER \ �, /SIGNATURE OF GENERAL PARTNER Corporation (. ...L.....7.................. NAME OF PRESIDENT SIGNATURE OF PP ESIDENT Limited Liability Company..................................................................................... /] NAME OF MyEMBBE NAGER SIGN W OF MEMMBE�RJMANAGER [ ]City [ �I L ounty ot"y 1� ��G CAI.... ............ State/Commonwealt of ..... /..�..... ...`.!..... �............. ........ Subscri d, d a knowled d bRorm).r.\t, me, t is ..�.......... day of .......... ....................................... 20 .. fl by... , t.uX....... ........................................................................ NAME tTLI My commission expires....................................................... CLERK'S OFFICE - Filed in the Clerks' Office of the................................................................... Circuit Court on ......................................................... DATE ..................................................................................... . Clerk by T P Depu Clerk FORM CC-1050 (MASTER, PAGE ONE OF TWO) 05/08 JON R, ,CLERK VA. CODE § 59.1-69 Depu y Clerk