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CLE202200110 Application 2022-08-19
Zoning Clearance Application FOR OFFICE USE ONLY Clearance Number: Fee Amount: $ 61.36 Application fee: $59 + Technology Surcharge: $2.36 Receipt #: Date Paid: By: Check #: By: Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 4OY Albemarle County Uy II Community Development Qlm 401 McIntire Rd, Nonh Wing Chadotlesville, VA 22902 Phone 434.296.5832 Name: The BridgeLine E-Mail Address: director@diebridgeline.org Mailing Address: P.O. Box 7292, Charlottesville, VA 22906 Phone #: 434.989.1274 Tax Map and Parcel number and/or Address of the Business: 315 Winding River Lane - Suite 201 Charlottesville, VA 22911 Zoning: Staff will fill out if unknown Parcel Owner: Breezy Hill of Burketown LLC Owner's Address: P.O. Box 7292 Charlottesville VA 22906 Check any that apply: K] New Business ❑ Change of use ❑ Change of Ownership Change of Name Business Name: The BridgeLine Description of Business' Describe the business including use, number of employees, number of shifts, availability of parking, and any additional into. Offices of The BridgeLine, a non-profit organization 501(c)(3) serving adults with brain injuries in a non-therapeutical non -medical way. 5 employees will work at this location; work shift 8:30-4:30; 13 parking spaces available Previous Business on Site: Unknown 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: 3,300 SF Is the Parcel Zoned LI, HI, or PDIP? Yes ❑x No If yes, fill out a Certified Engineers Report (CER) Will there be food preparation? Yes No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? x❑ Public Private If on private well, provide Virginia Department of Health approval Is the Parcel on public sewer or septic? x❑ Public Septic If on septic, provide Virginia Department of Health approval Will you be putting up any new signage? ❑ Yes K] No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes © No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit #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. Digu ysigoM by Wnwlz Pre r Daniela Pretzer �e_ p2iM�=� �l�,Wea99 �5 Daniela Pretzer for The BridgeLine Signature Printed Date 08/09/2022 R� Op ALR Zoning Clearance Application �2 Albemarle County O r Community Development 401 McIntire Rd, North Wing Chatlottesville, VA 22902 yRCIN�P Phone 434296.5832 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, The BridgeLine clearance number provided by Staff or business name to Breezy Hill of Burketown LLC the owner Name of landowner on record of Tax Map and Parcel Number 07800-00-00-058c3 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) x❑ Hand delivering a copy of the application to the owner identified above on Date 08/10/2022 ❑ Mailing a copy of the application to the owner identified above on Date to the following address: (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) Digitally signed by Daniela Pretzer Daniela Pretzer DN cn=Daniela Pr@thebr=The ne.orgLine, ou, email=director@thebridgeline.org, c=US Signature of Applicant Date: 2022.08.1915:51 :34-04roo, Applicant Name Printed Date Daniela Pretzer for The BridgeLine 08/09/2022 3 For Albemarle County Staff Review Only Proposed Use: Permitted: ❑ Yes ❑ No Permitted by Section: Supplementary Regulations: Applicable Special Use Permit (SP): Applicable Rezonings (ZMA): Applicable Site Plans (SDP): 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: Defined by: ❑Site Plan ❑ Zoning Ordinance ❑ Coo ❑Existing Total Square Footage of the Use: Required number of parking spaces: Associated Clearances: Variances: 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 ❑ Denied ❑ Backf low 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 Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4