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CLE202100122 Application 2021-09-20
ca°f ue 2 Albemarle County Zoning Clearance Application i Community Development 401 McIntire Rd, NOM Wing Ch Ghatlottesville. VA 22902 °jnrtN�t' Phone 434.296.5832 FOR OFFICE USE ONLY Clearance Number: I - I p- Fee Amount: $ 61.36 Date Paid: COP By: APPROVED Application fee: $59 + Technology Surcharge: $2.36 / 1 by the Albemarle County Receipt #�`�PfQ`6�4NkN Check #: C4� Bnity Development Department a - 9'2--c` 2- f Applicant - Fill out the entire page below and return to: File Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: Danielle Free / Presence Psychiatric Services E-Mail Address: DFree@presence.healthcare Mailing Address: 1010 Ednam Center, Office 201, Charlottesville, VA 22903 Phone #: 434-989-5656 Tax Map and Parcel number and/or Address of the Business: 0502-01-00-010131 1010 EDNAM CTR, Office 201, Charlottesville VA 22903 Zoning: Staff will fill out if unknown Corn For Business or Retailing Parcel Owner: Ednam, LLC Owner's Address: udd, PO Box 577, ivy, VA22945 Check any that apply: New Business ❑ Change of Use Change of ownership Change of Name Business Name: Describe the business including use, number of employees, number of shifts, availabilityof parking, and any additional info. Description of Business: Psychiatric services both in person and via telehealth provided by a licensed Psychiatric Mental Health Nurse Practitioner, one employee, greater than 20 parking spaces Previous Business on Site: N/A Floor Plan: Please attach either an architectural drawing or a sketch of the proposed business indicating the location of uses, the uses of rooms, the total square footage of the use, and any additional information. Total Square Footage Used for the Business: 225 sq It Is the Parcel Zoned LI, HI, or PDIP? Yes No If yes, fill out a Certified Enoineer's Report (CER1 Will there be food preparation? 0Yes No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? 2 Public Private If on private well, provide Virginia Department of Health approval Is the Parcel on public sewer or septic? Z Public Septic If on septic, provide Virginia Department of Health approval Will you be putting up any new signage? Yes Lad No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes Q No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit #s: N/A Zoning Clearance review cannot begin until the application above is complete and all applicable forms and fees are submitted. This Clearance will only be valid on the parcel for which it is approved. If you change, intensify, or move the use to a new location, a new Zoning Clearance will be required. I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Danielle Date 09/01/2021 �2�Y OE u�- Albemarle County Zoning Clearance Application j Communiire Rd,orthW 1'� 401 onesvee. North Wing U Charlottesville. VA 22992 ��ROIN�P Phone 434.296.5832 Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either informed or are going to inform the owner of your zoning clearance application. CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER I certify that I will provide (or have provided) notice of this clearance application, Presence Psychiatric Services, LLC cC.1=20Z1 _ 1 ZZ clearance number provided by Staff or business name l Ednam, LLC c/o Charles Rothenberg, Hirschler Law crothenberg@hirschierlaw.com 2100 East Cary Street to Richmond, VA23223-7078 the owner Name of landowner on record of Tax Map and Parcel Number 059D2-01-00-010B1 by either delivering a TMP number of property copy of the application to them in person or by sending them a copy of the application by mail. (Please check one of the following below) ❑ Hand delivering a copy of the application to the owner identified above on Date 0 Mailing a copy of the application to the owner identified above on Date 09/01/2021 to the following address: Ednam, LLC c/o Charles Rothenberg, Hirschler Law cothenberg@hirschlerlaw.com 2100 East Cary Street Richmond, VA 23223-7078 (Written notice to the owner and last known address on our record books will satisfy this requirement. Please see staff for help determining this information if needed) Signature of Applicant Applicant Name Printed Danielle Free Date 09/01/2021 i< For Albemarle County Staff Review Only Proposed Use: ,v 66-e 2 Permitted: ❑ Yes ❑ No Permitted by Section: 23, 2,1 `Z) 1 Supplementary Regulations: Applicable Special Use Permit (SP): Lu 2 z' Applicable Rezonings (ZMA): ^ 71 — 2 2 Applicable Site Plans (SDP): 11 $ 1,— 12 Parking: If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some parking requirements are determined by a ZMA or by an approved Code of Development. Parking Formula: 'tt D 5 D At Defined by: ❑Site Plan ❑Zoning Ordinance ❑ CoD ❑Existing Total Square Footage of the Use: 215 41) Required number of packing spaces: .0 5 I'L8r �d 61 Yj olyjv,"P pep, fb) jtS,211Z) Associated Clearances: 2© -'. I — `Q 2cp t l . 177, z01 '7 — ZY Variances: [gZ—YQ cwyb e Violations: �— Is a site inspection necessary?: ❑ Yes ❑ No - Site Inspection on (date): To Confirm: Notes: Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees Approval Information ❑ Approved as proposed ❑ Approved with conditions E Denied ❑ Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117 ❑ No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. ❑ This site complies with the site plan as of this date. Conditions: Additional Notes: Building Official Date Zoning Official <���� Date Other Official n.oe County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA22902 Phone: 434.296.5832 Fax: 434.972.4126 4 :d ;ufur m:nlOn :111w l;rtliva Parcel ID Primary Prop. Address Other Address(es) Subdivision Property Name Description Lot Property Card(s) Total Acres Tax Status 059D2-0I-00-OIOBI 1010 EDNAM CTR, UNIT 100 N/A Ednam Business District N/A ACREAGE2 010111 1.05 Reg. Taxable Owner EDNAM LLC Address 1010 EDNAM CENTER CHARLOTTESVILLE VA, 22903 Owner as of Jan 1st 1010 EDNAM LLC n: ftcccnt Amcsnlem Inluru r:0-1 Year Assessment Date Land Value Land Use Value Improvements Value Total Value �u Recent Sales llklor,% Previous Owner Owner Sale Date Sale Price Deed Book/Page t :l !idol rat, lur.I,I State Code Tax Type Parcel Level Use Code ., . :, JI:,' ,... 2021 01/01/2021 $702,600 $0 $624,100 $1,326,700 1010 EDNAM LLC EDNAM LLC 04/01/2021 $2,312,500 5511/300 Com For Business or Retailing Reg. Taxable Office Building EXHIBIT A Attached to the Lcase Agreement between Fdnam. LLC and Presence Psychiatric Sen ices, PLLC dated Soy) c 29* 10 PREMISES FLUOR PLAN