The URL can be used to link to this page

Home My WebLink AboutCLE201500055 Application 2015-04-17Applicati®n for Z®nlnClearance �d3 CLE # 7-015 _ 5'� OFFICEUS ONLY PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff: PARCEL INFORMATION I n Tax Map and Parcel: 07200-00-00-03200 Existing Zoning Kit ca it PY-PQ S Parcel Owner: Miller School of Albemarle Parcel Address: City State Zip (include suiteorfloor1000 Samuel Miller Loop, Charlottesville, VA 229 PRIMARY CONTACT Who should we call/write concerning this project? Ruth Stornetta Address: 807C 2nd St NW City C-ville State VA Zip 229-02 Office Phone: (434) 982 3977 Cell# 242-3144 Fax# E-mail rs3j@virginia. edu .- APPLICANT INFORMATION Check any that apply: _ Clhangee of ownership Change of.use Change of name New business Business Name/Type:1A tn'N ` V Previous Business on this site Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide ra kin and registration for bike race run under direction of Alb Co Po ice "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. 1 hereby certify that I own or have the owner's pemrission to use the space indicated on this application. 1 also certify that the information provided is true and accura}atpvthe. best n 1nowledgell have read the conditions of approval, and I understand them, and that I will abide by them. `of, Signature 4 Printed Ruth Stornetta APPOVAL INFORMATION Approved as proposed [ ] Approved with conditions j ] Denied j ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977.4511, x1].7. ] 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 omplics with the site pan as of this date Notes: Building Official Date L4' Zoning Official Date C Other Official Date 3' Intake to complete the following: Y/ Is us n LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y a. ':/ Wi ere be food preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the on applies Is parcel on rivate w or public water? If private wel , provide Health Department form. Zoning review can not begin until we receive approval fi•om Health Dept. FAX DATE Circle th net applies Is parcel on septic r public sewer? Will u be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y /jNJ Will ' re be any new construction or renovations? If so, obtain the proper Permit. Permit # Znninu to complete the following: Reviewer to complete the following: Square footage of Use: Rermitted as: f Under Section: 8A ILIA) 8 MIA Supplementary regulations section: Parking formula: Required spaces: �-- Y/ be verified in the field: Inspector: Notes: Viol •ions: Y/N� If s List: ProjTey: YNJ Ifs ist: Vari rrc.; Y/N1 Ifs 'Mst: ZZo SP's: Y/� If so, st: l Clearances: SDP's57 0 1 U' Revised 7/1/2011 Page 3 of 3 qII(P115 APPRO AL DATE Remarks: Virgirli#3 Departrr»nt XV D 13T of Transportation LAND USE PERMIT LUP-SEA Special Event Approvals / August 26, 2014 NTY ADMINISTRA7rOR /'PWN MANAGER Ofd DESIGNEE APPROVAL DATE LOCAL LAW ENFORCEMENT AGENCY Remarks: APPROVAL DATE VIRGINIA STATE POLICE (Sergeant/Area/Division) Remarks: APPROVAL DATE VDOT REPRESENTATIVE Remarks (include any changes that may be made by VDOT): Cc: County/Town Administration Local Law Enforcement Virginia State Police VDOT Residency Office / Maintenance AHQ I' 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, j [County application name and number] was provided to Miller School the owner of record of Tax Map, [name(s) of the record owners of the parcel] and Parcel Number 07200-00-00-03200 by delivering a copy of the application in the manner identified below:- . x -Miller School Hand delivering 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 April -S; x2{3.1-2- May 31, 2015 7 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] Oil to the following address: Date <I i� [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], ignaturc of Applicant Ruth Stornetta Print Applicant Name i 4 4/53 ala1-2a 3/30/15 - Date } 2014 Special Events Check List Your permit will be reviewed for approval as submitted under the following conditions: • Traffic and Race Control must be coordinated with and under the direct supervision of the Sheriff's Department for your locality. Provide a copy of the written Agreement. • Certified Flaggers with vests are to be posted at intersections as determined by the Sheriff's Department. Flagmen Ahead and Be Prepared to Stop Signs should be used at any intersection controlled by flag personnel or County Police. • Control the run area with barrels or cones • 'Emergency Vehicles Must be Able to and Allowed to Pass' • The following are to be notified of the Special Event/Race: Local Post Office and Emergency Services or others as directed by the Sheriff's Office. • Five days prior to the event Announcements must be made by the Local Media indicating the time and location of the event in order for local residents to plan accordingly. • The Routes should be policed for trash and debris at the conclusion of event and disposed of properly. • Keep your permit on site for the entire event Persons to whom permits or permissions are granted shall at all times indemnify and save harmless the Commonwealth Transportation Board, members of the board, the Commonwealth of Virginia and all Commonwealth employees, agents and officers from responsibility, damage or liability of the privileges granted in such permits or permission. It must be understood that the permittee will adhere to all the contingencies as stated above. Signature of Event Coordinatorpermit Applicant Date PgiI�e(- j3 I' L. Event Name Revision Date: 3/2010 Commonwealth of Virginia Department of Transportation LUP-A LAND USE PERMIT APPLICATION APPLICATION is hereby made for permit as shovm on the accompanying plan or sketch and as described below. Said activity(s) will be done under and in accordance with the rules and regulations of the Commonwealth Transportation Board of Virginia, in so far as said rules are applicable thereto and any agreement between the parties herein before referred to. Where applicable agreements may be attached and made a part of the permit assembly including any cost responsibilities covering work under permit. Applicant agrees to maintain work in a manner as approved upon its completion. Applicant also hereby agrees and is bound and held responsible to the owner for any and all damages to any other installations already in place as a result of work covered by resulting permit. Applicants to whom permits are issued shall at all times indemnify and save harmless the Commonwealth Transportation Board members of the Board, the Commonwealth and all Commonwealth employees, agents, and offices, from responsibility, damage, or liability arising from the exercise of the privileges granted in such permit to the extent allowed by law. In consideration of the issuance of a permit the applicant agrees to waive for itself, successors in interest or assigns any entitlements it may otherwise have or have hereafter under the Uniform Relocation and Assistant Act of 1972 as amended in event the Department or its successor, chooses to exercise its acknowledged right to demand or cause die removal of any or all fixtures, personality of whatever kind or description that may hereafter be located, should this application be approved. Driver's license or Tax ID number B24-60-6239 Contact Name Ruth Stornetta Owner Name Ruth Stornetta E-mail Address _rs3j@virginia.edu Address 307 C 2`1 St NW Phone Number ( _434_) _242_-_3144 City _Charlottesville State —VA—Zip Code -22902_ Emergency Number (_434—) _242-_3144 Fax Number ( 434_) _295 - 4716 Driver's license or Tax ID number Contact Name Agent Name E-mail Address Address Phone Number ( ) - City State Zip Code Emergency Number ( ) Fax Number Permit Term Requested _5/31/15_ Fees Enclosed S Check Number Coupon Number(s) Money Order Other Estimated cost of work to be performed on VDOT Right of Way S Surety Information: Surety Company Name Amount of Surety $ Obligation Amount $ The Surety posted by Owner ( ) or Agent Check N Bond # ILC # [ ] Corporate Surety [ J Resolution ] ] Ordinance [ ] Waived Applicant has provided proof of the following requirements in accordance as defined in Code of Virginia section 2a-1.151.1. (1) The utility company has registered as an operator with the appropriate notification center. (2) Attached is a notarized affidavit, stating that the utility owner has notified the commercial and residential developer, owner of commercial or nnlltifrimily real estate, or local government entities with a property interest in any parcel of land located adjacent to the property over which the land use is being requested, that application for the permit has been made. Request Permission: To perforin the following activity(s) _to conduct bicycle race with rolling traffic enclosure under the direction of the Albemarle County Police on route 635,637,708,696,692 as per attached plans. Location: Tax Map Number Applicant Job No. Geographically in County/ Town/ City of Albemarle_ On Highway Route and /or Name_635,637,708,696,692 Between Route St. Name Latitude Longitude And Route St. Name Latitude Longitude 1 I IE APPLICABLE, 1 AGREE TO PAY '.111E FULL SALARY AND EXPENSES OFA ST.A.LT1s ASSIGNED INSPECTOR IN CONJUNCTION WITH THIS PROJECT, COVERED BY ACCOUNT RECEIVABLE NUMBER. Signature of applicant Signature of agent Title president Date _3/30/15. Title Date All applicable items on this form must be completed to avoid delay in processing the issuance of a VDOT Land Use Permit. Prepayment Required - make Remittance payable to Virginia Department of Transportation. VDOT USE ONLY Receipt is hereby acknowledged for: CHECI{ No. COUPON No. M.O. No. In The Amount of $ for Permit Fee $ Cash Surety $ Authorized VDOT Signature: Date Miller School Bike Race, VA State Championships May 31, 2015 Castleberry c, ivy vmev --- Court Peacock Hill Police 2 Ie6ds �ande�t Midway AiLCM Rosemont Tattershall Police Farm Ragged 1 Dlck Woods Rd Retriever Mountain Farm CM Run ; eq'r`r�t`ft�terYt� i'0 aj y Ivy vista lou F�nta i f Murray tesvllle road closurek nsert a p p o'Parking at Miller School , Police CM Wish �= 6landemar Q Farm Estates B ; _M `S` 3 tillhouse Ca ROe'g ft -v r Ridge Ferrrincr ,v C Fa'm ai tandemar ' A Q F� n" luleddlebranch a a Fa >: dge. Valley S. South; Fork - Police 4 Farina ranch Miran Forest hoes" Plan for Bike Race May 31, 2015 Yellow stars indicate fixed police stations for traffic control Pre -race meeting at the Canteen at Miller School at 7:45 am July 27 Access to parking from 64 -250 -Miller School Rd, police at intersection of Miller School and Dick Woods Rd for controlling traffic influx Police at other major intersections as noted for traffic control, course marshals at less busy intersections will be VDOT certified flaggers Course runs clockwise (rt hand turns) Course marshal at driveway top of Miller School Rd to control exiting traffic from Miller School Race finish at Pounding Branch Rd and Miller School Rd (gravel parking area for race officials) After finish, racers proceed on Miller School Rd to the Miller School service entrance Rd to return to their cars/parking area 4 groups of racers leave Miller School driveway onto Miller School Rd at 8:30 am, 8:40 am, 8:50 am and 9 am to finish by 12:30 3 groups of racers leave Miller School driveway at 1:00, 1:10, 1:20 to finish by —4:00 pm 1 group will leave at 1:25 for 1 lap SPECIAL REQUEST to close the stretch of Miller School Rd from the intersection with Dick Woods Rd to the service entrance to the Miller School for short periods of time (-5 min) while race comes through