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Home My WebLink About06-19 ApplicationTo be completed by Planning Staff Zoning Amendment Number L� Date Received Fee Amount Paid $ � Anticipated PC Hearing Date �• " �� Anticipated BOS Hearing Date" � t REZONING APPLICATION FREDERICK COUNTY, VA DEPARTMENT OF PLANNING & DEVELOPMENT 1. Property Owner(s) (please attach additional page(s) if more than two owners): Name: Winchester Medical Center, Inc. Specific Contact Person if Other than Above: Mark Baker Address: 1836 Amherst Street, Winchester, VA 22601 Telephone: (540) 536-4543 Name: Specific Contact Person if Other than Above: Address: Telephone: Email: mbaker@valleyhealthlink.com Email: 2. Other Applicant Party (such as a contract purchaser) (please attach additional page(s) if necessary): Name: Specific Contact Person if Other than Above: Address: Telephone: Email: 3. Law firm, engineering firm, or other person, if any, serving as the primary contact person for this application: Firm Name: Valley Engineering, PLC Specific Contact Person at Firm: Daniel Michael, PE Address: 4901 Crowe Drive, Mount Crawford, VA 22841 Telephone: (540) 434-6365 Email: dmichaelC@valleyesp.com Please note that, if a law firm, engineering firm, or other person, other than the owner of the property, will be acting on behalf of the owner and/or executing papers on behalf of the owner in connection with the rezoning, the owner will need to execute a power of attorney form granting the firm or person such authority. Page 12 4. Project Name (if any): Winchester Medical Center II 5. Property Information: a. Property Identification Number(s): 53-A-68 b. Total acreage of the parcel(s): 89.4099 c. Total acreage of parcel(s) to be rezoned (if other than whole parcel(s) is being rezoned): d. Current zoning designation(s) and acreage(s) in each designation: B-2 - 37.5424 AC, MS - 51.8675 AC e. Proposed zoning designation(s) and acreage(s) in each designation: B-2 - 37.5424 AC, MS - 37.5424 AC £ Magisterial District(s): Gainseboro g. Location - the property is located at (give street address(es) if assigned or otherwise exact location based on nearest road and distance from nearest intersection, using road names and route numbers): 1998 Northwestern Pike, Winchester, VA h. Adjoining Properties: Parcel ID Number Use Zoning 53-B-3, 83 C STORE - LIVESTOCK EXCHANGE RA 53-A-84 RESIDENTIAL RA 53-A-75,76,77 RESIDENTIAL B-2 53-A-74 RESIDENTIAL B-2 53-A-73 RESIDENTIAL RA 53-A- 69,1 AGRICULTURAL RA 53 -A -68A HOTEL B-2 Property identification numbers, magisterial districts, and deed book and page numbers/ instrument numbers may be obtained from the Office of the Commissioner of the Revenue, Real Estate Division, 107 North Kent Street, Winchester, VA 22601. Page 13 6. Disclosure of real parties in interest. Virginia Code § 15.2-2289 provides that localities may by ordinance require any applicant for a zoning amendment to make complete disclosure of the equitable ownership of the real estate to be affected including, in the case of corporate ownership, the name of stockholders, officers, and directors, and in any case the names and addresses of all real parties of interest. Frederick County has, by County Code § 165-101.09, adopted such an ordinance. For each business entity that is an owner or contract purchaser of the property, please list the name and address of each person owning an interest in, or who is an officer or director of, any entity that is an owner or contract purchaser of the property (you need not indicate the amount or extent of the ownership interest). Please note that this requirement does not apply to a corporation whose stock is traded on a national or local stock exchange and having more than 500 shareholders. NOT APPLICABLE AS VALLEY HEALTH IS A NON-PROFIT ENTITY Please attach additional page(s) if necessary. 7. Checklist. Please check that the following items have been included with this application: Z Location Map P-1 I Plat Depicting Metes/Bounds of Proposed Zoning 0 Impact Analysis Statement Proffer Statement (if any) ❑� Agency Comments Fee Copies of Deed(s) to Property(ies) Tax Payment Verification Digital copies (pdf's) of all submitted items Page 14 7. Signature(s): I (we), the undersigned, do hereby respectfully make application and petition the Frederick County Board of Supervisors to amend the zoning ordinance to change the zoning map of Frederick County, Virginia. 1(we) authorize Frederick County officials to enter the property for site inspection purposes. I (we) understand that the sign issued when this application is submitted must be placed at the front property line at least seven days prior to the Planning Commission public hearing and the Board of Supervisors public hearing and maintained so as to be visible from the road right-of-way until the hearing. I (we) hereby certify that this application and its accompanying materials are true and accurate to the best of my (our) knowledge. Owner: k&- Date If signing on behalf of an entity, please state name of entity and your title: Owner: Date If signing on behalf of an entity, please state name of entity and your title: Other Applicant Party (if any): Date If signing on behalf of an entity, please state name of entity and your title: If additional signature lines are necessary, such as if more than two persons are owners, please use additional copies of this page. Page 15 AD.101NINO PROIDL,R i y V VJXTE"Q Owners of property adjoining the land will be notified of the Planning Commission and the Board of Supervisors meetings. For the purpose of this application, adjoining property is any property abutting the requested property on the side or rear or any property directly across a public right-of-way, a private right-of-way, or a watercourse from the requested property. The applicant is required to obtain the following information on each adjoining property including the parcel identification number which may be obtained from the office of the Commissioner of Revenue. The Commissioner of the Revenue is located on the 2nd floor of'the Frederick County Administrative Building, 107 North Kent Street. Name and Property identification Number Address Name FARMERS LIVESTOCK EXCHANGE PO BOX 2696 WINCHESTER, VA 22604 Property#53-B-3, 83 Name KEVIN L. ANDERSON 180 THURSTON CT CLEARBROOK, VA 22624 Property # 53-A-84 Name NANCY RENNER JOHNSON 2054 NORTHWESTERN PIKE WINCHESTER, VA 22603 Property#53-A-75, 76, 77 NameCRT PROPERTIES, LLC 424 W CECIL ST WINCHESTER, VA 22601 Property # 53-A-74 Name MARSHA A. DEHAVEN AND JANCICE P. LLEWELLYN 500 S HAYFIELD RD WINCHESTER, VA 22602 Property # 53-A-73 Name FRUIT HILL ORCHARD, INC PO BOX 2368 WINCHESTER, VA 22604 Property#53-A-A, 69, 1 Name WINCHESTER HOTEL PARTNERS, III LP 610 EDGEGROVE RD HANOVER, PA 17331 Property # 53 -A -68A Name Property # Name Property # 16