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0 9
SITE PLAN APPLICATION
- Office Use Only -
Date Application Received: 'Application #:
Fees Received: 0 CPO Receipt #: �a 1" Initials:
Project Title: Eastern Supply -Wash Rack Building
Location of Property
(Street address)
200 McGhee Road
3. Applicant/Designer:
Name: Greenway Engineering, Inc
Address: 151 Windy Hill Lane
Winchester, VA 22602
4. Property Owner (if different than above):
Name: T.S.M., Inc
Address: 240 McGhee Road
Winchester, VA 22603
5. Property Information:
a. Property Identification Number:
b. Total acreage of the parcel to be developed:
c. Total disturbed area of the parcel:
d. Present Use:
e. Proposed Use:
f. Magisterial District(s)
8
Telephone: 540 - 662 -4185
Telephone: 540 - 722 -3292
43 -19 -1 B
<8,000 SF
5.28 acres
Warehouse, office, outdoor storage
Wash rack
Stonewall
6. Site Plan Type:
a. Is this an original or new site plan?
b. Is this a revised site plan?
If yes provide all previous site plan numbers:
c. Is this a minor site plan?
If yes provide all previous site plan numbers:
7. Zoning Information:
Yes II
Yes Jv
Yes II✓
65 -07
No
No
No
a. Current Zoning: M1
b. Was this property Rezoned? Yes J__L No ✓
c. If yes provide the rezoning number for this property:
d. Are there any proffers for this property? Y
e. Has a MDP been approved for this property? Y
es No
Y(
f. If yes provide the MDP number for this property:
8. Adjoining property zoning and use:
USE
North Commercial
East Industrial
South Industrial
West Manufacturing
No
II
ZONING
M1
M1
M1
M1
I have read the material included in this package and understand what is required by the Frederick County Planning
Department. I also understand that all required material will be complete prior to the submission of my site plan.
Signature:
Date: ,June 28, 2012
9
Special Limited Power of Attorney
County of Frederick, Virginia
Frederick Planning Website: www.co.frederick.va.us
Department of Planning & Development, County of Frederick, Virginia
107 North Kent Street, Winchester, Virginia 22601
Phone (540) 665 -5651 Facsimile (540) 665 -6395
Know All Men By These Presents: That I (We)
(Name) T.S.M., Inc
(Phone) 540- 722 -3292
(Address) 240 McGhee Road, Winchester, VA 22603
the owner(s) of all those tracts or parcels of land ( "Property") conveyed to me (us), by deed recorded in the
Clerk's Office of the Circuit Court of the County of Frederick, Virginia, by
Instrument No.
on Page , and is described as
Parcel: 43 Lot: 1B Block: 19 Section: Subdivision:
do hereby make, constitute and appoint:
(Name) Greenway Engineering, Inc
(Phone) 540 - 662 -4165
(Address) 151 Windy Hill Lane, Winchester, VA 22602
To act as my true and lawful attorney -in -fact for and in my (our) name, place and stead with full power and
authority I (we) would have if acting personally to file planning applications for my (our) above described
Property, including:
_Rezoning (including proffers)
Conditional Use Permit
Master Development Plan (Preliminary and Final)
Subdivision
M
✓ Site Plan — Minor'
Variance or Appeal
My attorney -in -fact shall have the authority to offer proffered conditions and to make amendments to previously
approved proffered conditions except as follows:
This authorization shall expire one year from the day it is signed, or until it is otherwise rescinded or modified.
In witness thereof, I we) hav� hereto set my (our) hand �qd seal this 1 n14 day of , 20 (a ,
A A F \ /
Signature(
State of Virginia, City/County of i5n d ec L1L , To -wit:
I, Ah,, p -1 ' i( 2 S , a Notary Public in and for the jurisdiction aforesaid,
certify that the person(s) who signed to the foregoing instrument Vrsonally appeared before me and has
acknowledged the same before me in the jurisdiction aforesaid this � day of, 20�.
j &Q�= Az& o My Commission Expires:
Notary Public
ALISA BRILES
Commonwealth of Virginia
Reg. #7512319
Commission Expires 0-