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Home My WebLink AboutCLE201700007 Application 2017-04-21Application for Zoning Clearance,°` CLE # LQ 1-1- 00:] y �%J2GiN\P PLEASE REVIEW ALL 3 SHEETS OFFICE USERNLY Check # d Date: 1-1 Receipt # AU Staff: �) PARCEL INFORMATION Tax Map and Parcel: 1010 0-0 0 -0 0 -0 5 6A0 Existing Zoning RA Parcel Owner: Albemarle Co Schools Parcel Address:4217 Red Hill Rd City Charlottesville State VA Zip 22903 (include suite or floor) PRIMARY CONTACT Who should we call1write concerning this project? Ruth Stornetta Address: 307C 2nd St NW City Charlottesville State VA Zip 22902 Office Phone: ( 434) 982-3977 Cell # 434-242-3144 Fax # E-mail rs3j@virginia.edu APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: Monticello Velo Club/non-profit bicycle club 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: BOGY Glo raG@ ro9,strat,on and for Bike rase on April 2, 2017 parking *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 1 will abide by them. Signature _ ;' . �' ' : Printed Ruth Stornetta APPROVAL INFORMATION Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117. [ ] 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. Notes Building Official Date Zoning Official Date ��12.,I� Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Is/ Is USLI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y WilNkde 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 ies Is parcel o ate or public water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the o Is parcelo septic o ��,e er? Y/N Will you be putting up a new sign of any kind? Sign permit. Permit # If so, obtain proper Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zonin2 to com lete the following: Reviewer to complete the following: Square footage of Use: /N Permitted as: Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector: Notes: Date: Violations: If /� If so, t: Proffers: Y If sot: Vari c Y/ If so, List: SP's Y/N If so, ist: Clearances: SDP's Revised 11/1/2015 Page 3 of 3 2017 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. _1/02/17 Signature of Event Coordinator/Permit Applicant Date _Jefferson Cup Bike Race Event Name 2017 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. _1/02/17 Signature of Event Coordinator/Permit Applicant Date _Jefferson Cup Bike Ra Event Name Jefferson Cup Road Race April 2, 2017 Race plan: Meet and start at Walton Middle School One police officer leads each race group First race group (3 races doing multiple laps) leaves at 9:00 am Break at noon Second race group ( 3 races doing multiple laps) leaves at 12:30 pm Third race group (3 races doing multiple) leaves at 2.45 pm Last race should end by 5:45 pm Police Traffic control at intersections with red squares Races start at Walton School and proceed onto Red Hill Rd and route 20 as a parade. Once races turn off route 20, proceed to "start". 1 st race stops, then starts again at "start". 2nd and 3rd race groups proceed to start and wait appropriate intervals to be spread around course so as not to interfere with the other groups. Races finish at "start" and racers return to Walton School on their own. Communication with help of Albemarle Amateur Radio Club and hand held business radios Race radio will be provided for each police car leading a race. zO Walton •7.° School `9 ate E Vemuont Co START endow /► stases ,.. Blen d Blenheim Vpe%, Estates 0 �J Blenheim �:arn • i, V!� I� W s ;:reek Fami Blenheim Beer Rime M Commonwealth of Virginia LUP-SP Department of Transportation o LAND USE PERMIT 12/2010 Special Provisions NOTICE OF PERMITTEE LIABILITY Permittee Agreement for Land Use Permit Issuance I the undersigned hereby acknowledge that I am fully cognizant of all of the following requirements associated with the issuance of a VDOT Land Use Permit: Applicant Name: Ruth Stornetta Applicant Signature: Project Name: Jefferson Cup Bicycle Race Route Number: 20, 627, 727, 708 County: Albemarle Any of the following provisions that may apply, shall apply: Permittee acceptance and use of a Virginia Department of Transportation (VDOT) Land Use Permit is prima facie evidence that the permittee has read and is fully cognizant of all required permit provisions, applicable traffic control plans and associated construction standards to be employed. ALL 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 officers, from responsibility, damage, or liability arising from the exercise of the privileges granted in such permit to the extent allowed by law. 2. The permittee agrees to secure and carry insurance against liability for personal injury and property damage that may arise from the work performed under permit and/or from the operation of permitted activity -up to one million dollars ($ 1,000,000) each occurrence to protect the Board members and the Department's agents or employees; seventy-five thousand dollars ($75,000) each occurrence to protect the Board, the Department, or the Commonwealth in event of suit. 3. The permittee assumes full responsibility for any and all (downstream flooding, erosion, siltation, etc.) damages that may occur as a result of the work performed under this permit. Furthermore, the Department will in no way be responsible for any damage to the facility being placed as a result of future maintenance or construction activities performed by the Department. 4. The permittee agrees to move, remove, alter, or change any installation that interferes with the ultimate construction of the highway in alignment or grade at NO cost to the Department unless otherwise stipulated and agreed to by the Department. 5. The permittee shall immediately correct any situation that may arise as a result of these activities that the district administrator's designee deems hazardous to the traveling public. 6. Any and all highway signs, right-of-way markers, etc., disturbed as a result of work performed under this permit shall be accurately reset by the permittee immediately following the work in the vicinity of the disturbed facility. The services of a certified land surveyor with experience in route surveying may be required. the permitted activity does not involve the installation, maintenance and removal of work zone traffic control devices. 18. Traffic shall NOT be blocked or re-routed (detoured) without written permission from the district administrator's designee. 19. During construction, the permittee shall furnish ALL necessary signs, flag persons and other devices (lights, barricades, etc.) providing protection for traffic and workers in accordance with the Virginia Work Area Protection Manual or as directed by the district administrator's designee. 20. ALL signs shall be in accordance with the current edition of the Manual of Uniform Traffic Control Devices (MUTCD). 21. Trained, certified flag persons shall be provided in sufficient number and locations as necessary for control and protection of vehicular and pedestrian traffic in accordance with the MUTCD. The flag person shall carry their certification card while performing flagging duties within state maintained right-of-way. Any flag person found not in possession of his/her certification card shall be removed from the flagging site and the district administrator's designee will suspend all permitted activities requiring flag persons. Furthermore, flag persons performing duties improperly shall have their certification revoked. Authorized Hours and Days of Work 22. Normal hours for work under the authority of a permit single use or district -wide are from 9:00 a.m. to 3:30 p.m. for all highways classified as arterial or collector. All highways classified as local roads will have unrestricted work hours and days. The classifications for all state maintained highways can be found at the following link: http://www.viriziniadot.or2/proiects/fxn class/maps.asp 23. Permitted non -emergency work will not be allowed on arterial and collector highway classifications from noon on the preceding weekday through the following state observed holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day. If the observed holiday falls on a Monday, the permit will not be valid from noon on the preceding Friday through noon on Tuesday. 24. The district administrator's designee may establish alternate time restrictions in normal working hours for single use permits. 25. The central office permit manager may establish alternate time restrictions in normal working hours for district - wide permits. Emergency Repair 26. In the event of an emergency situation that requires immediate action to protect persons or property, work may proceed within the right-of-way without authorization from the district administrator's designee; however, the permittee must contact the VDOT Emergency Operations Center as soon as reasonably possible but no later than 48 hours after the end of the emergency situation. 27. The permittee must apply for an after -the fact emergency repair permit single use permit at the local VDOT permit office when the following actions are proposed: • Stopping or impeding highway travel in excess of 15 minutes, or, • Accessing facilities within limited access right-of-way, or, • Cutting the highway pavement or shoulders. The district administrator's designee shall determine the applicable permit fee and surety for emergency repair permits. 37. Whenever existing pavement is permitted to be cut, not over one-half of the roadway width shall be disturbed at one time and the first open cut trench section shall be satisfactorily restored to allow for the passage of traffic prior to the second half of the roadway surface can be disturbed. 38. The surface pavement restoration shall extend a minimum of 25' on each side of the trench centerline for open cuts perpendicular to the roadway alignment (See LUP-OCPR for details). The extent of pavement restoration for all other pavement cuts shall be determined by the district administrator's designee. 39. The contractor shall complete all pavement restoration within 10 calendar days of completion of installation of the underground facility. 40. ALL crossing of existing pavement shall be bored, pushed or jacked an appropriate distance from the edge -of - pavement so as not to impede the normal flow of traffic or damage the existing pavement section. Existing pavement shall NOT be cut unless approved by the district administrator's designee and then only if justifiable circumstances prevail or proof is shown that a thorough attempt has been made to push, bore or jack. 41. Where the pavement is disturbed or deemed weakened in its entirety or such portions as deemed desirable by the Department, the pavement shall be restored or replaced in a manner that is satisfactory to the district administrator's designee. Environmental 42. In accordance with the Virginia Department of Transportation (VDOT) Road and Bridge Specification § 107.14 (a), Special Provision 107D, all contractors performing regulated land disturbing activities within VDOT right- of-way must have at least one (1) employee that has successfully completed the VDOT Erosion & Sediment Control Contractor Certification training. This person shall be on site during all land disturbance activities and will be responsible for insuring compliance with all applicable local, state and federal erosion and sediment control regulations during land disturbance activities. This person must have their certification card with them while on the project site. The land use permit will be suspended if proof of certification cannot be provided. Regulated land disturbing activities are defined as those activities that disturb 2,500 square feet or greater in Tidewater, Virginia (as defined in § 10.1-2101 of the Code of Virginia) or 10,000 square feet or greater in all other areas of the State. The Department will require evidence of this certification with any Land Use Permit application that involves utility and/or commercial right of way improvement. Improper installation, maintenance and removal of erosion and sediment control devices may result in revocation of VDOT Erosion & Sediment Control Contractor Certification. 43. The permittee is responsible for pursuing and obtaining any and all environmental permits which may be required to pursue the proposed activity prior to any work beginning within state maintained right-of-way. 44. In the event hazardous materials or underground storage tanks are encountered within state maintained right-of- way during authorized activities, the permittee shall suspend all work immediately then notify the local VDOT district permit office and other responsible parties, i.e., the local fire department, emergency services, Department of Environmental Quality, etc. The permittee is responsible for coordination and completion of all required remediation necessary to complete the permitted activities within the state maintained right-of-way. The permittee shall provide evidence of such compliance to the local VDOT Residency Office or Permit Office prior to recommencement of permitted activities. 45. In the event cultural resources, archaeological, paleontological, and/or rare minerals are encountered within the right of way during authorized activities, the permittee shall suspend all work immediately then notify the local VDOT district permit office and the proper state authority charged with the responsibility for investigation and evaluation of such finds. The permittee will meet all necessary requirements for resolving any conflicts prior to continuing with the proposed activities within the state maintained right-of-way, and shall provide evidence of such compliance to the local VDOT district permit office. Final Inspection and Completion of Permit 55. Upon completion of the work covered by this permit all disturbed areas outside of the roadway prism shall be restored to their original condition as found prior to starting such work. 56. Completion of this permit is contingent upon the permittee's completion of the authorized work in accordance with the approved plan and compliance with ALL governing bodies involved in the total completion of work on state maintained right-of-way. 57. Upon completion of the work under permit, the permittee shall provide notification, documented in writing or electronic communication, to the district administrator's designee requesting final inspection. This request shall include the permit number, county name, route number and name of the party or parties to whom the permit was issued. The district administrator's designee shall promptly schedule an inspection of the work covered under the permit and advise the permittee of any necessary corrections. Revision Date: 3/2010 ' Commonwealth of Virginia Department of Transportation LUP-A LAND USE PERMIT APPLICATION APPLICATION is hereby made for permit as shown 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 pennit 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 We 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 the 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 211 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 3/30/14_ Fees Enclosed $ Check Number Coupon Number(s) Money Order Other Estimated cost of work to be performed on VDOT Right of Way $ Surety Information: Surety Company Name Amount of Surety $ Obligation Amount $ The Surety posted by Owner ( ) or Agent Check # Bond # ILC # [ ] Corporate Surety [ ] Resolution [ ] Ordinance [ ] Waived Applicant has provided proof of the following requirements in accordance as defined in Code of Virginia section 2.2-1151 1 (1) The utility company has registered as an operator with the appropriate notilication center. (2) Attached is a notarized affidavit, stating that the utility owner has notified the commercial and residential developer, owner of commercial or multifamily 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 perform the following activity(s) to conduct bicycle race with rolling traffic enclosure under the direction of the Albemarle County Police on route 20, 727, 627, 708 as per attached plans. Location: Tax Map Number Applicant Job No. Geographically in County / Town / City of Albemarle_ On Highway Route and /or Name_20, Between Route St. Name Latitude And Route St. Name Latitude 727, 627, 708 Longitude_ _Longitude_ I I IF APPLICABLE, I AGREE TO PAY THE FULL SALARY .AND EXPENSES OF A STATE ASSIGNED INSPECTOR IN CONJUNCTION WITH THIS PROJECT, COVERED BY ACCOUNT RECEIVABLE NUMBER. Signature of applicant Signature of agent Title_president Date _1/02/17, Title Date All applicable items on this form must be completed to avoid delay in processing the issuance of a VDOT Land Use Pen -nit. Prepayment Required - make Remittance payable to Virginia Department of Transportation. VDOT USE ONLY Receipt is hereby acknowledged for: CHECK No. COUPON No. M.O. No. In The Amount of $ for Permit Fee $ Cash Surety $ Authorized VDOT Signature: Date