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HomeMy WebLinkAbout03-15 Application5 Submittal Deadline'TL�5115. P/C Meeting I 1(D -1 BOS Meeting l r,r y r CATION FOR CONDITIONAL USE PERMIT FREDERICK COUNTY, VIRGINIA 1. Applicant (check one): Property Owner _� Other NAME: ADDRESS: lO N Fai f fit x Pike Wh,►'t f &s +, UA ;;66-? TELEPHONE: .moi 44 a - "S' 0 - 40 5 o 2. Please list all owners, occupants, or parties in interest of the property: 9GA0Lf1!N E LlE Yl Qi ei'c f The property is located at: (please give exact directions and include the route number of your road or street) 4. The property has a road frontage of feet and a depth of feet and consists of acres. (Please be exact) 5. The property is owned by 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 Magisterial District 6pea use n Current Zoning .� R F1 Adjoining Property: USE ZONING North East South West 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 Nameni 1 14C. . / s 3,2 Fq I r -F,7 x < <� c Property # -/39 Name pinS ^ Property # V7 7 - %9 -Vr 13 Name Property # Name 3 Q Property # Name looni° ' (mmall 160 Property # O `� - "/ N C1111Ocv1-*—'tW i so d U' i q X r Properly# � - A - Name & li r ct) d A i cWf i L4% Fc, i ci X ' )< C Property # 7 . 9 0 0 Name and Property Iden/tificfation Number Address Name Le �� t / q' f `7� �i Ci r Property # Name Property # 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. 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 Applicant Signature of Owner Owners' Mailing Address Owners' Telephone No. ;5Iqo 96 9 e9a'<0 TO BE COMPLETED BY THE ZONING ADMINISTRATOR: USE CODE: RENEWAL DATE: 9 9 E HISTORIC RESOURCE ADVISORY BOARD REVIEW APPLICATION a � Frederick County 107 North Kent Street, Suite 202 MEETING DATE Winchester, Virginia 22601 Telephone: (540) 665-5651 Fax: (54065-6395 DATE STAMP Description of Application: Please describe briefly the request of the application: (rezoning, master Jdevelo ment 1 conditional use ermit . Please e s ifi . CP V e - j This application is not complete until all of the following information has been provided to the Department of Planning and Development. Please check the materials that have been submitted. FCopy of required application as described in 1.1 (1.1.1-1.1.4) nDescription of proposed development or construction project, including proposed uses and general timeframe for development (1.2) Status of any identified historic or archaeological resources on the site or adjacent to the site (e.g., located in any identified historic area, survey area, or battlefield site or individually listed on a local, state or national historic register, relevant information on record with the Virginia Department of Historic Resources) and presence of other historic structures or significant landscape features or archaeological sites; (1.3) IIPhotographs (color) of all historic resources on the property (1.4) PROPERTY IDENTIFICATION NUMBER PI — Name of A licant: Telephone Number (6 110 — Address: Street Ci K t ie f05,j State Zip Code.2al f; Signature: Print Name: ff /" 'S Date: C/' i Please note that the applicant or his/her appointed representative must be present at the meeting. :1