HomeMy WebLinkAbout07-04 CommentsREQUEST FOR CONDITIONAL USE PERMIT COMMENTS
Winchester -Frederick County Health Department
107 North Kent Street, Suite 201
Winchester, Virginia 22601
(540) 722-3480
The Winchester -Frederick County Health Department is located in the County Administration
Building at 107 North Kent Street in Winchester, if you prefer to hand delivered this form.
Applicant's name, address and phone number:
Cc e
Name of development and/or description of the request:
Location:
Health Departmen Comments:
Signature and Date:
.-1z-6jy
NOTICE TO APPLICANT
It: is your responsibility to complete this form as accurately as possible in order to assist the
agency with their review_ Also, please attach a copy of your application form, location map and
all other pertinent information.