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P/C Meeting �.
BOS Meeting
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APPLICATION FOR CONDITIONAL, USE PERMIT
OFREDERICK COUNTY, VIRGINIA
1• Applicant (The applicant if the _�
01
,� � owner other)
NAME: l 11 r)r 1 ,mit L i�l1"t r^ /"�A
ADDRESS:
TELEPHONE
2.
Please list all
the property:
owners, occupants, or parties in interest of
3. 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 /z'L
depth of -3 X') feet and consists of feet and a
(Please be exact) --`� acres.
5. The property is owned by
evidenced by deed from as
recorded
in deed book no. (Previous owner)
records of the Clerk of the - as recorded in the
Frederick. Circuit Court, County of
-7 LO3
0
6. Tax(Parcel)Identification (I.D. )No.
Magisterial District
Current Zoning --L,) G
7. Adjoining Property:
North USE ZONING
East
South
West
8. The type of use proposed is (cons{ult Wit thetilannipq,-JDept.
before completing) ��r•��c-J'rr j :,1��( �� �, <:: 1 �r_:•
9. It is proposed tha1ti�the following buildings will be
constructed: ``kj'.
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 (ro> C i r;, Tin. ADDRESS
PROPERTY ID# .
PROPERTY ID# f 9(�/ C
NAME 1 L C ADDRESS
C} �=ry ���//Eki:; l2
PROPERTY ID# �1�INC.� �,'�i�c ��'�>3
NAME :� �/Z.G�(ter` - C1, h .� ADDRESS
PROPERTY ID#
NpME%' �•�Ci.[� ADDRESS
PROPERTY ID#
NAME ADDRESS
PROPERTY ID#
NAME t r �r; i,.i-.<- r' �c ADDRESS.•PY
PROPERTY ID# �'- 11A���`
NAME C; C� t^. LG) b ADDRESS t Ck l r I--
PROPERTY ID# CACI- V
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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10/28/2005 16:55 5405421183
THIS IS TO CERTIFY THAT ON
OCTOBER 27, 2005 THAT I Q
MADE AN ACCURATE SURVEY n�•
OF THE PREMISES SHOWN
HEREON AND THAT THERE ARE :vim'
NO EASEMENTS OR
ENCROACHMENTS VISIBLE ON
THE GROUND OTHER THAN
THOSE SHOWN HEREON.
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l� THIS LOT IS LOCATED IN HUD
O FLOOD ZONE C, AREA OF
MINIMAL FLOODING AS
SHOWN ON FIRM MAP 510063
B EFFECTIVE JULY 17, 1978
CHRISTOPHER D-
FURSTENAU
No. 2727
HOUSE LOCATION SURVEY
LAND OF
RNTONIO PEREZ HFRNRNDEZ
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12. Additional comments, if
—i
any:(t.'.�, 1C r���.
F\ <<V JKtf0 i o rn`
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rad�iYYit_I ? t�
Y
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 prg.Derty where the proposed
use will be conducted.
Signature of Applicant
Signature of Owner
�r r
Owners' Mailing Address
i
Owners' Telephone No. ( > 1 041.1 t
TO BE COMPLETED BY ZONING ADMINISTRATOR•
USE CODE:
RENEWAL DATE: