HomeMy WebLinkAbout05-16 ApplicationSubmittal Deadline (Pilo, 11C
P/C Meeting_
BOS Meeting
APPLICATION FOR CONDITIONAL USE PERMIT
FREDERICK COUNTY, VIRGINIA
1. Applicant (check one) Property Owner _ Other j t Y-CIV
NAME:
ADDRESS: Aal- CaLkw Q, k
TELEPHONE: Q
2. Please list all owners, occupants, or parties in interest of the property:
3. The property is located at: (please give exact directions and include the route number of
your road or street)
4. The property 4.aka road frontage of 1. ,eet and a depth of feet and
consists of acres. (Please be exact)
The property is owned by C as
evidenced by deed from previous owner) recorded in
deed book no. on page , as recorded in the records of the Clerk of the
Circuit Court, County of Frederick.
6. Property Identification Number (P.I.N.) 1
Magisteri al Distri ct It e-Lil01
Current Zoning
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7. Adjoining Property:
USE
North Q % clS--V s
East,{'
South
West Y, l+y ,
ZONING
9.04
8. The type of use proposed is (consult with the Planning Dept. before completing):
9. It is proposed that the following buildings will be constructed:
10. The following are all of the individuals, firms, or corporations owning property
adjacent to both sides and rear and in front of (across street from) the property
where the requested use will be conducted. (Continue on back if necessary.)
These people will be notified by mail of this application:
Name and Property Identification Number Address
Name rig
Property #
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4
Name (l a'n ( a C-
Property # E -. 1-4
f
Name
Property #
Name
Property # '4 _ rp - /36
Name
Property # py
Name
Property #
Name
Property #
Name and Property Identification Number Address
Name
Property #
Name
Property #'j
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
11. Please use this page for your sketch of the property. Show proposed and /or existing
structures on the property, including measurements to all property lines.
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12. Additional comments, if any:
I (we), the undersigned, do hereby respectfully make application and petition the governing body
of Frederick County, Virginia to allow the use described in this application. I understand that the
sign issued to me when this application is submitted must be placed at the front property line at
least seven (7) days prior to the first public hearing and maintained so as to be visible until after
the Board of Supervisors' public hearing. Your application for a Conditional Use Permit
authorizes any member of the Frederick County Planning Commission, Board of Supervisors or
Planning and Development Department to inspect your property where the proposed use will be
conducted.
Signature of A
Signature of O
Owners' Mailing Address
Owners' Telephone No.
l je/
4ta - 112 - PJ fcl
TO BE COMPLETED BY THE ZONING ADMINISTRATOR:
USE CODE:
RENEWAL DATE: