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HomeMy WebLinkAbout37-05 Application• �' f l 2�i'^ ti I V JUN 5 .200 5 T. Project Title: 2.. Location; f Property, (street address) 3. Property Owner: Address: TeleohoniE: 4. Applicant /Agent. 'Address Telephone- 51. Designer;: Addressf Telephon'e: Contact: _-�SZ-K) W�o 6 6a.. Is this a standard -or `minor'.,site -plan? Standard Minor. 6b. Is this an original or revised site plar ? Original Revised 72... T6tal acreage of parcel to be,developed' I , 1 7b_ Total; acreage of parcel`: 8: Property Information: a) Property Identification Number: b) Current'Zoning:p3 c) ,Present Use' w'1 �: 2 , C � � Stof aA d) Proposed Use: e) Adjoining Property Use(s) C4\\ Cz ( -C\&C f) Adjoining Property Identification Nurriber(s) 75� CC A Z Q) Magisterial "District(s) 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: 7 Power ofAttoraey spec."iAttirriuM P0 ri V* Coun-trof Frederick, Virginia `Frederick Phin n in gW*eb Site: w,,ww.coAed'erIckva.us l 16 Virginia, Department;of Planning & Development,,County'd f ee . dM k, irgin, ' a,, 107 North K6t'Stre t,'Winchester, Virgiiiia,22601 a - Phone 540- 665-56.51 TCs imile 540T665-6395 Facsimile .Know All Men- By Those: Present: Tfiat.11 (We). (Name) (Phond) (Address) the owner(s) of all'thosbtracts ovpzircels of land ("Property') conveyed to me (us),, by deed recorded,in the Clerk'.s Ofice', of the C irc u it Cotrtof the County of Frede ick Virginia, by Instrument.No. on Page Parcel.:, ­Lot: -,Block' Setfidn, do hereby make, constitute and appoitit: (Name) and ,is dmiihod as Subdivision: (-Phone) (Address) ley-iii-facifor and' iii�rny r), name, place, To, act as mytrue and e, and stead with full power and authority 1 (we) would have if' Acting personally to fileplanning applications -for my (our), above described: Property,, including-., Q 'k.ezoning (including, proffers) 0 Conditional UsePermits 0 Nfaster DevelopmentTlan (Preliminary and Final) 0 Subdivision ❑ Sik Plan. ,My aftorneywin-fact shall have, the authority to offer, proffered conditions and to make' amendments to previously aPproved.profTered c6ndifiofts-ke-xcept as f6HOWsir This adihorizAtribRsh it.is. signed, orun kq;exl?Ke� on'- -ay in wftnJ6 fNerea' I (we) have hereto, set, an .my (our) hand and seal this ss. sigriature(s) State bf Virginia, ..'City/C in ou -iy of' is, otherwise rescinded of modified: - day of ; 200_, To-wit', I'allotary?ublic.iri and ,for the jurisdiction ,aforesaid; certify - thdt'the,, person(s), signed': to the :foregoing instrument, per'sofially,appeared b6ore me and has acknowledged the same, n aforesaid this day of ie� before rpq in thej"Urisdictio 200 My Conrimis-sion.Ex p i'res,*- Notary'Public� Request-for gife, Plan Comments Virginia Department of. Transportation, 'Hand, deliver to- Virginia Departm ont of 'Trafilsportatibn Virginia Department of Tran'slpbrtAtion Attu: Resident Engineer 2275: Northwestern Pike 1*4031 Old Valley Pike Winchester, Virginia 22603 Edinburg, Virginia, 22624 (540) 5,35-1818 984 - 5.600 'Ple,ase, fill outthe information 'as. accUf0teIV. as possible in orderto. Virginia, Department of Transportation With their review. Please attach five, (5),,c6plijes lof the site plan with traffic ,generation, data and-drainage cAll.0119(tionkwith this sheet. he(et, Applicant's: Name: Address: Phone Number: NaM.e bf,dev!plopment:and/6t,.d6sceip'ti6'n of the request: Location: of property 'Virginia Department of Transp joh's Comments: 1-3 Request F6e Site Plan Comments Frederick�County Fire: Marshal Ma'il';to: Hand deliver to Frederick County Fire Marshal 1.07 N.'Kent Street Attn: Director of Engineering First, Floor 107 North Kent- Street V\1inchpste,r, VA Winchester;, VA 22601 (540) 665 -6350 (540) 665- 6350 Phease fill out the information as accurately: as possible in order to assist the agency with their review: Please attach two (2) copies of'the site plan with this sheet. Applicant's Name:: n- Address:d Phone Number: Name of development and /or description of° :the reauest: Location of'property; 1 ,a ( 4 ":s r Fire Marshal's Comments: 18 Reguest, . For Site, Plan- 60mments', 'Fr6dedelk County, Inspections Department Mail "to: HandjeliiVer'W , F . rededck, County- Ins,pections Dept,., 107 N. Kent,, Street; Suite. 2.00, Attrv.:Bu.il-ding. Offidal North Building, 2 - "d' Floor 107 .-North 'Kent. Street Wiftchester, VA, Winchester, VA-22601 (54p),'665-565110 (5401)865=5650 Please fill out the information a.s accurately as possible in order t0' assist the agency with their, review:; Please attach one (.l')'cop ev , y of the site plan with, this.'sheet.. APO ica-IVS, Name- OAA Address:: Phone: Number- �. Name of �de , v10- " I and/ordesbription of the requ'ost! pmen CSI� Location of property, Inspections ,Department's Comments-* 16 Request Site; Plan C-ornmen'ts, Frederick - GoUnty,Enginteeing! Department Mail to: Frederick County Engineering, Dept: A',ttn,- Director of Engineering 1107 North Kent Street: Winchester; VA 22601 (540) 665-5643 Hand,deliver1q! 107R.KentStroet, 'Suite, 200 - North. Building, ,2 n d , - - Floor Wincl'fester, VA (5401) 665-5643 Please fill Out the information as: accurately as possible in order to assist the agency With their review. Please attach 'two ,(2)-copI'!EkSi:-'of thesite plan witlhithis slheet, Applicant's Name: Address: Phone Number: Name of �development andfor'd.estri,pti.on of the request; UV-1 �� S Engineering Department's Comments: 17 Request For. Site Plan Comments Frederick County SaijitAtion, Authorijy° Mail to Hand deliver to Freder , j'qk County Sanitati ' on Authority 3.15 Tastier, Road :Attu;; Engineer'Director Stephens City,, VA RO. Box 1'877 ($40) 86840,61 VVinchester, VA 22604 (540) 86'8-1061 Plaase fill out the information as accurately as possible, in orderto assist the agency with their review. -Please attachAw6 (2j copies sokhb.site,pjAn W -ihjws' i_ t i sheet Appli'cant's Name. Address: .Phone Number--. Mime of development and/or description of t . he request: U Location of property: F-r(ader.itk- . County .Sanitation ,,Authority",s Comments- 14 -Request For Site Plan Comments: 'Frederick County- Win`clesfer'Health: Department mail to Hand del verto: Fredefick- Winchester Health Department 1 "07 North ..Kent Street, Suite 201'. Attn; Sanitation Engineer Winchester, VA 107 North'Kent Street; :S,uite 201 (540) 722- 34.'80 Winchester; VA 22601 (,5,40),722-3480. Please fill out the information :as accurately as possible in order to assist the agency with their review. Please attach one (1) copy of the site ,plan with this sheet: Applicant's Name: Address: Phone,.Number. 5q �,bj^ 3YJ Name of development an /or descripton of-the request:. � AS b S l c Location of property: Health Dept's Comments ;20 r� Requesffor Street Name�Comments, Site Plan R`e�iew Frederick County Department of GIS ;(,Geographic Information` Systems). Attn Marcus Leirnasters,, GIS Manager, 107 North Kent Street, Suite 200 Wincheste( Virginia. 22601 (,540) 6654651 'The GIS Manager will ;review the proposed street. names for this project to ensure their °acceptability into the Frederick( Qouhty'streetname.$ystem Proposed street names will also be ,routed through. the GommunPication Center Supervisior, for review. This step will prevent duplicate street names.from being entered. Mease attach one copy of°the plan indicating proposed names. Applicant's Name: g)", Address: Phone Number: Name of developme ; ° a .d %or de`scripti`on of the Njjuest; CGi c Y01nPV, Location of property- ii RequestF-orSite Plan Comments Frederick County Depar'tment.of'Parks and Recre'ati'on: Mail to Hand deliver, to! ,Frederick .County Dept. Of Parks and''.Recreation 107 N. Kent Street Attn Director of Parks =and Recreatio_ n Second Floor 107 North Kent Street Winchester, VA, Winchester, VA.22601 (540) 665 -5678 (5,t0)' 665 -5678` Please fill out the information as accurately as possible in order to assist the; agency with their review. Please attach one (1;) copy of the site, plan with th'issh6et; Applicant's Name: _ T. UL L Address: Phone Number: Name of developret 4r description of the req`,uest; , /,y^^ s 1 Loy -ation of property: Parks and ;Recreation Dept's. Comments:_ t9 Winchester- Regin-al Airport Attn: Executive: Di "rector' 491 Airport Road Winchester,, VA 22602, (540) 6621-2422 1 Rig ugstFor Site-Plan Comments Winchester Rdg-i bnafAitpo Hand deliver W 491 Airport Road (Route, 645, off of Route5221 South) (5401) 662-2422 ,Please: fill out the information as, accumtQly as possible in order,to assist the agency with their review. Please attach gn"e. (1') copy of the site plan with this sheet. Applicant's Name, Address;. Phone NtImber- Name,of devolopme Lo6ation of property: Winchester Regi I onal.AirpQrtt.bmMen�fs of the request: 41-11 Winchester Regional Airport use WAY Date received Date revision received Date .appro-ved incomplete ',Date, reviewed Date reviewed' $i'gnature:and. Date Signature and' Date( , Fevisi6h) 25" Request For Site ,Plan. Comments Z- ty of Winchester Mail to:.; Hand deliver to: -, Winchester Planning Dept-. 1 °5' N. Cameron Street: Attn Planning Director Rouss. City, Hall 15.4. N; Cameron Street Winchester, VA Winchester; VA 22601 (540) 66.7-1`815 (540) 667 -1 °815 Please fill out °the information, as accurately as possible in order to assist the - agency with their review. Please attach one fl) ;copy �of the site plan with this sheet: Applicant's Name.: Address: Phone Number:U� 3s Name of develop- ent and/or description of the request: Location of. property. -'. _ Ciiy of Winchester's Comments '2'1 RequestTor Site,Plan Comments s: Town ,of'Stephens Civ, Mail to Hand deliver to: Town of ,Stephens City_ 1{033 Locust'Street ,Attu:° Town Manager. Sfephensw City Towni Hall P.O: Box 250 Stephens. City, VA Stephens >.City,'VA.2265'5 (540) 869-8,687 (540) 869 -3087 Please fill out fhe mformatio( ) s pyurately as ppssibie in order to assist, the agency, with their review. Please ai#ach one 1 co , of thesite ian-with this,sheet. Ap plicant',s Name, Address: Phorie Number: Raime of development and /or description of the request. Location of ro e p p rty:. .. Town of Stephens City Comments 22 Location ,of'property: Town of Mi'ddletow,n Comments°::_ 23 Request For Site'!Plan 'Gomments Town -of-Middletown M'ail_,to:: Hand de[iVdtI6 Town-of'Middletown 7875 Church Street A1.tn;: Town Manager Middletown Town Hall P.O.;'Box.96 Middletown, VA Middletown,. VA 2264'5 (540) 869 -2226 (540) 869-2226 Please, fill ,out the information as accurately as possible in order, to assist the agency' with, their review. Please attach one (1 j copy of the site plan with this sheet, Applicant's Narne:, Address Phone Number: Name of deVelopment,an&or description of the request: Location ,of'property: Town of Mi'ddletow,n Comments°::_ 23 Request: For 'Sif6I*Ptah Comments Departrnentpf Planning and',D6VeloprnerIt Marko., Hand'dldliiverto!' D6partmentof Planning and Development 1,07 N. Kent, Street Attn: : GOdh'ty Planner North Building, 2pd Floor 107 North Kent Street 'Winchester, VA `yVipche9tef, VA 22601 (540) 665-5651 (540) 605-56511 Please fill out the *urafely as possibte in ,order assist, the agency with their qs-a-cc... -, -1 1 — - I review. Please attach, two (2.) copies ,of the site plan with.thisl sheet. Applicant's Name: UIC Address: Phone Number:, Name of development. d/Or description ofthe request-.: Location Of property: Planning and DevelopmerIt's Comments'. 15 0