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HomeMy WebLinkAbout07-18 CommentsREQUEST FOR CONDITIONAL USE P Frederick County Inspe( Mail to: / Frederick County Inspections Department ,4� 107 North Kent Street, 2nd Floor gent Winchester, Virginia 22601 (540) 665-5650 Applicant: It is your responsibility to complete c) assist the agency with their review. Also, please attach t ►n map and . all other pertinent information. NA • P,e H. -S K q_s� ri Applicant's Name: IQ i r t t Telephone: 7e, 3 /y 7S- - y(�, c Mailing Address: 5C, i I f�,j t= y /3 K 0'1 G Ij rL2 a r1 D / /4 x \/A 2 2 6 > S Name of development and/or description of the request: L " ) r) �L-C r -. -7- P / C1 / R /-` � �► C-. S' % T �� �� r /�/ Z �-r r -t 0 u ,e.� � f''L C� f���-� Location of Property: L/ 7 Z C/�/� �' /ZTJ r T� i��1 /) i K, t= i Building Official's Comments: Building Official's Signature & Date: Notice to Inspections Department - Please Return This Form to the Applicant 12 REQUEST FOR CONDITIONAL USE PERMIT COMMENTS Winchester -Frederick County Health Department Mail to: Frederick -Winchester Health Department Attn: Sanitation Engineer 107 North Kent Street Winchester, Virginia 22601 (540) 722-3480 "a_A deliver 1— a Frederick -Winchester Health Department Attn: Sanitation Engineer 107 North Kent Street, Suite 201 Winchester, Virginia 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 two (2) copies of your application form, location map and all other pertinent flifom-iati0l). Applicant's Name: 10 Tc` 1z, J C J !.I Telephone: 703 - i-1 ts' 76 60 Mailing Address: I P;]VtFx 419 j/ �a Y IA _ / 19 2. 2- 4- d3 Name of development and/or description of the request: )IJ j' k -j C. H t-:- / C', I / /_ C Location of Property: j t,_3 &03, Frederick -Winchester Health Department's Comments: Health Dept. Signature & Date: Notice to Health Department - Please Return This Form to the Applicant 13 REQUEST FOR CONDITIONAL USE PERMIT COMMENTS Frederick County Fire Marshal Mail to: Hand deliver to: Frederick County Fire Marshal Frederick County Fire & Rescue Dept. 1800 Coverstone Drive Attn: Fire Marshal Winchester, Virginia 22602 Public Safety Building (540) 665-6350 1800 Coverstone Drive Winchester, Virginia 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 two (2) copies of your application form, location map and all other pertinent information.. "12- ��/Z _K14S.-4 /), Tr j Applicant's Name: W rJ L H r ..5 i t rZ / O 1 L L L Telephone: _% o 3 41 1-Sti g G It v Mailing Address: !7 C? i J P ; y k)i- R C -4 /` A% & /- /-? x V /3 2- 2 Q i p Name of development and/or description of the request: ty ; �J L-1 / r-) / L L Location of 6� i P -J1 lz--//-:=-< lL kZ/A ) L & 0 3 Fire Marshal's Comments: Fire Marshal's Signature & Date: Notice to Fire Marshal - Please Return This Form to the Applicant 11 HISTORIC RESOURCE ADVISORY BOARD REVIEW APPLICATION .O��K � CSO C Frederick County 107 North Kent Street, Suite 202 MEETING DATE Winchester, Virginia 22601 Telephone: (540) 665-5651 Fax: (540) 665-6395 DATE STAMP Description of Application: Please describe briefly the request of the application: (rezoning, master development plan, conditional use permit). Please be specific. ZV 7-0 6 0 Y %34 'fJK0 iwl - C T(, L,) ; A if 40 P L = 19 / C U rJ > /y - _ /- Ci` - Pe -,F-" Z JR13 AO t q S' ji G ®..� ., j N E 'crr '� �; /'r fJ 0 e K o 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. Copy of required application as described in 1.1 nDescription of proposed development or construction project, including proposed uses and general timeframe for development (1.2) ElStatus 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) F] Photographs (color) of all historic resources on the property (1.4) PROPERTY IDENTIFICATION NUMBER PIN Name of Applicant: t,' i y :_ r, / 1) G Tele hone Number (%3) y 7S = y O Address: Street % �(v' '' KtCitti t r hl Cr► j=,t; State ^,,p9 Zip Code l 16 42 Signature: / Print Name: P1414 /< -1 1-),4 ri L Date: / j Please note that the applicant or his/her appointed representative must be present at the meeting.