HomeMy WebLinkAbout009-91 (Revised) Libert Baptist Church - Opequon District - Backfile (2)It
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* STAFF SITE PLAN CHECKLIST *
This application is not complete if the following are not included:
1. One set of comment sheets from the following agencies along with any marked
copies of the plan;
IVA VDOT
/
Sanitation Authority
r-14 Inspections Dept.
Fire Marshal
County Engineer
Airport Authority
111114 City of Winchester
IV1 Town of Stephens City
Town of Middletown
Health Dept.
Parks & Recreation
/01" Soil & Water Conservation Dist.
2. One copy of the Site Plan application.
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3. Five copies of the Site Plan. '� �„� ca,., 5 n
4. One reproducible copy of the Site Plan (if required).
5. One 35mm. slide of the Site Plan (if required).
TRACKING
Date
Application received.
All necessary agency comments received.
Fee Paid (amount $ ).
/ Site Plan to Planning Commission via bi-monthly.
Site Plan heard by Planning Commission (if required).
Revisions received (if required).
Date of approval.
Info added to annual report diskette.
COUNTY of FREDERICIC
Department of Planning and Development
703/665-5651
FAX 703/678-0682
June 6, 1991
Mr. Jackie Battles
5029 Caroline Avenue
Stephens City, VA 22601
Dear Mr. Battles:
This letter regards the submittal of the Liberty Baptist Church
site plan that is proposed to be located along Route 277 in the
Opequon Magisterial District. The original site plan for this
project received administrative approval on June 8, 1990; however,
the site plan was resubmitted by Liberty Baptist to show the
relocation of the church and the parking area.
All required review agencies have approved their portions of the
revised site plan and Mr. David McClure has provided this
department with the appropriate number of revised plans; therefore,
I have recommended approval of your plan. Enclosed is a copy of
the revised site plan for your files.
If I may answer any questions regarding this letter or be of any
assistance, please contact me.
Sincerely,
V
Evan A. Wyatt
Planner II
EAW
cc: Mr. David McClure, A.I.A. Architect
THE COURTHOUSE COMMONS
9 N. Loudoun Street - P.O. Box 601 - Winchester, Virginia - 22601
0
•
DATE
SITE PLAN APPLICATION
APPLICATION # / Oo 9- 9/
Complete the following application:
1. Development Name:
2. Location of Proper'
(by street name)
3. Property Owner:
Address:
Telephone:
4. Applicant/Agent: It'le Jz:,'-zf S
Address:
Telephone:
5. Designer:
Address:
Telephone:
Contact:
�4 — a !z -14 --C,1
0
0
6. Is this an original or revised site Plan?
Original Revised
7. Total area of parcel to be developed:
8. Property Information:
a) Tax Map: 86-1
b) Parcel Number:
c) Tax ID # :
d)Current Zonin
e) Present Use:
f ) Proposed Use:
g) Adjoining Property Zoning:
h) Adjoining Property Use: Dy"4
i) Magisterial District:
U
I have read the material included in this package and understand
what is required by the Frederick County Planning Department. I
also understand that all re fired mater7,//
will be complete prior
to the submission of my si la
Applicant's Signature: �fi L,
I
C
APPLICANT'S CHECKLIST
Your site plan should include the following:
Administrative Information
Y N
_ 1. Name of proposed development
_ 2. Name and address of owner
3. Name and address of developer
P/ _ 4. Name, address, and phone number of designer
_ 5. Certificate of surveyor, engineer, or architect
6. Date plan prepared and date of revisions
7. A listing of all conditions placed on the site as a
result of a conditional use permit or conditional
zoning approval
8. A space labeled "approved by the Zoning
Administrator" for the approval signature and date
of approval
General Site Information
VR]
_ 9. Location map (scale 1:2000)
10. Magisterial District of site
_ 11. Scale of site plan (not to exceed 1:50)
12. North Arrow
13. Zoning of site
14. Use and zoning of adjoining properties
Lots/Uses/Buildings & Structures
Y N
15.
Surveyed boundaries for all lots and parcels
16.
Acreage of all lots included in the plan
17.
The location and dimensions of all required setbacks
and yard areas
18.
Location of all buildings, structures, and uses
_
19.
The proposed use of each building, structure, and
area
20.
The location and type of all dwelling units
21.
Ground floor area and total floor area of all
buildings with FAR calculations for commercial and
industrial zoning districts
22.
The height of all buildings and structures
23.
The location and dimension of all signs
7
Lots/Uses/Buildings & Structures (con't)
Y N
24.
Location
of
outdoor lighting fixtures
_
25.
Location
and
nature of outdoor storage areas
✓,
26.
Location
and
area of common open space
_
27.
Location
and
description of all recreation facilities
_
28.
Location
of
sidewalks and pedestrian ways
_
29.
Location
of
outdoor trash receptacles
Roads
Y N
30. Name and number of existing and planned streets on
and adjoining the site
_ 31. Location of existing and planned streets on and
adjoining the site
_ 32. Dimensions, boundaries, width, pavement, and
construction of planned roads
33. Location and dimensions • of all proposed
entrances from public right-of-ways
Utilities
Y N
_ 34. Location of all utilities, including sewer and water
lines with the size of lines, mains, and laterals
PZ _ 35. Location and width of all easements, including
access, utility and drainage easements
36. Location and nature of fire lanes, fire hydrants,
and all other facilities necessary to meet the Fire
Code requirements
Parking
Y N
37. Calculations describing the required number of
parking and loading spaces
_ 38. Location and dimensions of all parking and loading
spaces, driveways, parking aisles, curbing, and
other features to be used
39. Location and dimension of all handicapped spaces
E:3
Natural Features
Y N
_ 40. Existing and finished contour lines
t1l_ 41. Location of steep slopes, woodlands, floodplains,
wetlands, sinkholes, and other environmental
/ features
/ 42. Location of streams and drainage ways
Landscaping
Y N
43. Landscaping plan describing location and types of
plants to be used
44. Location of required buffers and screening with cross
sections or profiles
Erosion and Sediment Control
�• Wl
45. A stormwater management plan with run off
calculations and location and description of
facilities to be used
46. Soil erosion and sedimentation control plan with
location, types, and examples of provisions to be
used
9
COUNTY OF FREDERICK, &INIA •
DEPARTMENT OF INSPECTIONS
Caller JACK iE �D.a-R �t�-: Time Called 9 ' 30 tq Date Called tIzz %4 L
Phone No. 869 - 4, G TH Time Requested A SAP Date Requested ¢/7-3[N.
Received By E:VA,3 A Y[y+nt" Date of Inspection
4-1-731-1(.
PERMIT HOLDER NAME L�$E�m BnP-nST 0-4oe-G4
RT. NO. 01 Lot No. � SEC. No. SUBDIVISION
STREET NAME FR1eFAX r1KiL--
DIRECTIONS Z' $ I -Tn Evs r 30-7 BUILDING NO.
Try,jEL. C ktyr otJ Z7-7 • PLUMBING NO.
C_4'_)Zc.L} 00 SoyTN SiDCZ:" ELECTRICAL NO.
/4PPQDIC 3 m i MECHANICAL NO.
SIGN NO.
DISTRICT OPC:Quor�
PERMIT FOR: KIQAJ Cttt1(IGM Fn-clL.lr�
Type of Inspection
Residential
6e Aa wreieF e. W a c N
Footers
Setbacks: FR
BK L
R
Slab
Draintile
Gas Fire -up
Final Electrical
Water
Service
Framing
Final Mechanical
Sewer
Rough Electric
Final i
Site Plan
Rough Plumbing
Rough Mechanical
Final Building
Fire Marshall
r'
Groundworks y
Gas Piping/Test
Final Plumbing
Special/Complaint
Other:
Time In:
I0Od
Temperature
-1 5'b F Cut in No.
Time Out:
Weather
Sy►Jr.)
Results: Approved Rejected
Comments: i.Cl1X 4lerl-
Signature LJa" a - Date ,Z3 I �l
COUNTY OF FREDERICK, VIRSIA
•
DEPARTMENT OF INSPECTIONS
Caller ACKIC &TR..__
J
Time Called
Date Called
Phone No. 80
Time Requested
A sR P
Date Requested A Si -e
`(�
Received By !— A
/
'y4-Ti -
Date
Inspection
•
of
PERMIT HOLDER NAME Li
a,;
.s-r- tt-,1 R.C-N
RT. NO. 277 Lot No.
SEC. No.
SUBDIVISION
FA
n
STREET NAME ► kFWk
{"I K
DIRECTIONS I" 8 1 - n
Ex rT 30^7
BUILDING NO.
7
PLUMBING NO.
Ct++-)PcH
co 50 )n-t
ok:_
ELECTRICAL NO.
A-frR"
3 Mit_lr: _
MECHANICAL NO.
SIGN NO.
DISTRICT �jp
t►oKi
PERMIT FOR: O fnti Ii]r2C
14 I I_►
Type of Inspection
I
t..
! ►eC�4
Residential
Gowd"efciai
Footers Setbacks: FR
BK
L R
Slab
Draintile
Gas Fire -up
Final Electrical
Water
Service
Framing
Final Mechanical
Sewer
Rough Electric
Final
Site Plan %
Rough Plumbing
Rough Mechanical
Final Building
Fire Marshall
Groundworks
Gas Piping/Test
Final Plumbing
Special/Complaint
Other:
Time In: = 03 rN
Temperature
-75 eI=
Cut in No.
Time Out: 3 ' 7-7 U4
Weather
400M tyj N r3Y
Results: Approved Rejected
1
Comments: [pn%PLEXE 44-g-,tJ& LOT- Tr_►P►'3i'"`
(,,L,,. cr
Signature a. , Date `j bb
COUNTY OF FREDERICK, VIRGINIA
DEPARTMENT OF INSPECTIONS
Caller JACkiL�_ 'Dfl-tTs Time Called Date Called S 10
Phone No. 8(_19 - iO`SgSJ Time Requested 10:001±1 Date Requested 11 193
A Received By 1:z'J J y /t+1 Date of Inspection
PERMIT HOLDER NAME Li awaTY &-rern S i l rruRCH
RT. NO. 7- 7 7 Lot No. SEC. No. SUBDIVISION
STREET NAME FA+r.r-,,4X PiKt p
DIRECTIONS BUILDING NO.
l'10 �ADT' 00 74F. Z-77 t7rpp0)(. PLUMBING NO.
Z •H AA S I-17 nQ SO-J-114 ELECTRICAL NO.
SIDC- 0�= RT Z-71 MECHANICAL NO.
PERMIT FOR: NEW C►WIZCH F-AC+LlN
Tvoe of Inspection
Residential
Footers
Slab
Water
Sewer
Rough Plumbing
Groundworks
Other:
Time In: IQ e
Time Out:
Setbacks: FR
Draintile
Service
Rough Electric
Rough Mechanical
Gas Piping/Test
SIGN NO.
DISTRICT V{'CL UOr
CHURC I-
BK L
R
_ Gas Fire -up
Final Electrical
_ Framing
Final Mechanical
/
Final
Site Plan ✓J
_ Final Building
Fire Marshall
_ Final Plumbing
Special/Complaint
Temperature fi 85- F Cut in No,
Weather 5�►.►�1/
Results: Approved ✓ Fla,aL_ C• U• Rejected A
Comments: COMPL+ �= JTA(�I,_+,A'-10113 OF CAa0rn A-kcF, ,.
G
�rlD ant'L.L BE ASQNA��r Cooctcrc wtfttL_
Sr�i'S f'�iZllt APPI_Iu_� AiZ l:tS.
Signature 5i)(1zq wG�+'Ot -- Date /I1 /93
COUN"r( OF FREDERICK, VIR06IA 40
DEPAp,TMENT OF INSPECTIONS
Caller _..
�1+cKlE 84 — Time Called 9 3C>81 . Date Called %Zs�43
Phone ��9 - ("Sig` Time Requested Asp�-P Date Requested 1A-SAP
Recei•ia/S �-V 1Jj-a3 A - �\/Y i� Date of Inspection 3 / 2 1 3
PERMIT HOLDER NAME
RT. 7--7-7 tLot No. SEC. No. SUBDIVISION
STREET NAME �/�tRFIZV7C iii�Cc
DIRECTtORJG �i"t BUILDING NO. 75 1 a l 9 1
Co G" 6tJ -R • 2:-77 R-PPrmx PLUMBING NO.
7 g M I L ES ; S i TIE Qrl SOO 5 t-t
_ ELECTRICAL NO.
2_ 7 % MECHANICAL NO.
SIGN NO.
DISTRICT — 0FiZ:Q Uos'J
PERMIT FOR: N � (2,h)12C.H- F�ciL,ml
Type of Ins ection
Residentlal
Footere Slab
Water
Water -
Sewer -
Rough Plumbing -
Groundworks -
Other: _--•—
Setbacks: FR
Draintile
Service
Rough Electric
Rough Mechanical
Gas Piping/Test
Time In: 8`574vq Temperature
Time Out: Weather
�. rMa_ei ('_ H") �Z_c i I
BK
Gas Fire -up
Framing
Final
Final Building
Final Plumbing
OVt.�-+4S s
Resulm Approved FOCZ 1 EKP. (30-0O3P,MJ'-/Rejected
L R
Final Electrical
Final Mechanical
Site Plan
Fire Marshall
Special/Complaint
Cut in No.
Date
.i ;.
COUNTY OF FREDERICK, VIRAIA •
DEPARTMENT OF INSPECTIONS
Caller JACK1E %i�* Time Called 1a:60."� Date Called 313 /9 3
Phone No. $bl — (oC`i S Time Requested o1SAP Date Requested ASnP
i
Received By &rAQ A . Date of Inspection Ja 3
PERMIT HOLDER NAME f I au- P--N �A PTl_ �TCttu cc F
RT. NO. Z- 7 _� Lot No. 1� SEC. No. SUBDIVISION
STREET NAME K—:� f AV,c:_7
DIRECTIONS -D STtv X IT BUILDING NO.
<n EAST (SrJ R—� 2.7 7 Ar('FDX . PLUMBING NO.
Z ul DES S i n r� Sc� t►'T1-+ ELECTRICAL NO.
T
SI OF Z_7 "] MECHANICAL NO.
SIGN NO.
DISTRICT Op ac�UO,J
��
Ct T;N
PERMIT FOR: .:�
uKc- C
1 ►_1124
Type of Inspection
Residential
► 44&!21 � C►+y RC H
Footers
Setbacks: FIR
BK L R
Slab
Draintile
Gas Fire -up Final Electrical
Water
Service
Framing Final Mechanical
Sewer
Rough Electric
Final Site Plan
Rough Plumbing
Rough Mechanical
Final Building Fire Marshall
Groundworks
Gas Piping/Test
Final Plumbing Special/Complaint
Other:
Time In: vrt Temperature 1 35 1= Cut in No.
Time Out: Weather rJ
APPLICA 4 o►J o,= 6r_'-" Ln_\.t� S
Results: Approved 1�'m �r+rNo s pR.-"'R Rejectedlava.'y` OF I` P. C•O, b�we��c� AL,,O)
• Z
Comments: A
A 1 1
@tit -+1c
Siqnature _
®ro".r_� J) aP,-S
Date
w
5/8/93
• �y, ..' '
00 S P At� 009 -9 1
F#W
COMMONWEALTH of V1RCjINIA
RAY D. PETHTEL
COMMISSIONER
Mr. H. E. Strawsnyder, Jr., P.E.
County of Frederick
P. O. Box 601
Winchester, VA 22604
DEPARTMENT OF TRANSPORTATION
P. 0. BOX 278
EDINBURG. 22824
October 20, 1992
WILLIAM H. BUSHMAN
RESIDENT ENGINEER
TELE 1703) 984-4133
FAX (703) 984-9761
Ref: Liberty Baptist Church
Route 277
Frederick County
I am writing in regard to the above referenced project. When commenting to the Planning
Department on the proposal in May, 1990 we indicated we had no objections to the site plan
other than some minor changes needed to the entrance design. Furthermore, we stated a land
use permit would be required to cover work activities on the State's right-of-way. Prior to this
in May, 1989 we met with and issued a private entrance permit to Mr. Jackie Battles, Pastor in
order to access the property for construction purposes.
At this point, as you are aware, the building is well under construction and should be completed
in the near future. However, Pastor Battles has yet to apply for a land use permit to cover
construction of the required commercial entrance. We have met with and spoke to him by phone
on several occasions to explain our requirements; the last time being in April of this year. He
indicated he understood our requirements and he or his agent would be applying for the permit
shortly. Although we have no reason to believe otherwise, we have yet to receive a permit
application. Therefore, in order to insure the safety of the traveling public is not compromised,
we respectfully ask your Department deny an occupancy permit for the structure until our land
use permit requirements have been met. As always your cooperation and help will be
appreciated.
Sincerely,
William H. Bushman
Trans. Resident Engineer
By: Robert B. Childress
Hwy. Permits & Subd. Spec. Senior
RBC/rf D
Enclosures
xc: Mr. R. L. Moore
Mr. John Riley
Mr. R. W. Watkins TRANSPORTATION FOR THE 21 ST CENTURY
22W2
COMMONWEALTH H of VIRCjINIA
DEPARTMENT OF TRANSPORTATION
P. 0. BOX 278
RAY D. PETHTEL EDINBURG, 22824
COMMISSIONER (703) 662-8876
May 15, 1989
Mr. Jackie Battles, Pastor
Liberty Baptist Church
Stephens City, VA 22655
Dear Pastor Battles:
WILLIAM H. BUSHMAN
RESIDENT ENGINEER
Ref: .Private Entrance Rte. 277
At: 0.66 Mi. E. Route 636
Frederick County
According to your request, you have permission and will be required to do the
following items to your entrance:
- While working on the right-of-way, it will be necessary to erect signs
according to the Virginia Department of Transportation's standards prior to
starting work and to remove these signs daily.
- A minimum of 30 feet of 15 inch approved culvert pipe will be required.
- If rock is encountered which requires drilling and/or blasting, the entrance
is to be graded by you with no cost to the Virginia Department of
Transportation.
- You will be required to place crushed stone from the right-of-way to the
edge of the roadway.
- All graded slopes are to be 1 1/2:1 or flatter and you will be required to
topsoil and reseed all disturbed turf on the State's right-of-way.
- You will be required to flatten the slopes in a uniform manner and restore
them to the satisfaction of the Virginia Dep rtmeht of Transportation.
- The ditch line will have to be restored.
- After completing the work, you will be required to stabilize the roadway or
shoulder with crushed stone.
- All work is to be completed within 180 days.
- Should this land parcel subdivide or develop commercially, this private
entrance will be invalid. The applicant will be required to apply for a new
permit which fits the circumstances appropriately.
TRANSPORTATION FOR THE 21 S T CENTURY
May 15, 1989
- Page Two -
0
- The entrance is to be constructed at the location we agreed upon at our
meeting last December. This location provides the best possible sight
distance. It should be understood before your church is allowed to open, you will apply for a land use pe=t to construct a commercial entrance to
our minimum standards.
This permit does not grant permission to grade on the property of others or
disturb in anyway utility poles or underground lines. Also, I am attaching a
copy of a sketch of our standard private entrance for your information.
Should you have any questions during construction and upon completion, please
notify the area superintendent so he can check this work.
Sincerely,
W. H. Bushman
Resident Engineer
P 6r . o4t,�
By: R. B. Childress
Hwy. Permits & Subd. Spec. Sr.
/rh
Attach.
xc: Zoning Administrator's Office
Mr. D. E. Lee
r
REQUEST FOR
OUNTY of FREDER1Ch
Department of Planning and Dcvclopment
•7031 665-565x,
SITE PLAN COMMENTS FAX 703i667-037C
Virginia Department of Transportation
ATTN: William H. Bushman, Resident Engineer
P.O. Box 278, Edinburg, Virginia 22824-0278
(703) 984-4133
The local office of the Transportation Department is located at
1550 Commerce Street, if you prefer to hand deliver this review
form.
Applicant's name, address and phone number:
��2iV f �/�-f�i � f''r'J-��1.oC- �'�: �-9 /•� �n��,Qi �P '�7"�;'L�, -C �� 7 � (� i ��
Name of development and/or description of the request:
Location:
G• 4
f c �' S7'-��ho„�$ Cr'�`' 04
�!4%t f Si� o ,, C�a J /��o•, s %2 �»r/r � 201 �1C.: s� _ Co cfiflc
�[ .o
�/ R P c flS . � q 17o n/ Y o r � Cron] GA-7 e Mq,,
transportation Department Comments:
No OBJECTION TO SITF PI AN TF ANY 1,lnR'{ Ts Pc4FnRMFT) nNj THE gjaTF'c DTrWT- ,.rnY�
A LAND USE PERMIT WILL NEED TO BE APPLIED FOR AND ISSUED TO COVER SAID WORK.
SOME MINOR CHANGES IN THE COMiMERICAL ENTRANCE DESIGN WILL BE NECESS ?Y PRIOR TO
APPROVAL OF THE ENTRANCE PERMIT. THE PERMIT IS ISSUED BY THIS OFFIC= AND REQUIRES
A FEE AND SURETY BOND COVERAGE. y�
VDOT Signature and Date:
(NOTICE TO VDOT - PLEASE RETURN THIS FORM TO THE APPLIC_-\:T.)
NOTICE TO APPLICANT
It is your responsibility to complete this form as accuratdly as
possible in order to assist the agency with their review. Also,
please attach THREE copies of your plans and/or application form.
9 Court Square
P.O. Box 601
Winchester, Virginia
22601 ..
i COUNTY of FREDERICK
Harvey E. Strawsnyder, Jr., P.E.
Director of Engineering & General Services
7031665-5643
FAX: 703;678-0682
SITE_PLAN-COMMENTS
FREDERICK COUNTY ENGINEER
9 NORTH LOUDOUN STREET, 2ND FLOOR
WINCHESTER, VIRGINIA 22601
(703) 665-5643
DATE: May 2, 1991
PROJECT: Liberty Baptist Church
DESIGNER: David E. McClure, A.I.A.
COMMENTS
1. The stormwater calculations submitted with the
site plan do not reflect a comparison of the 10
year pre -development and the 25 year
pest -development storms considering the changes
in runoff coefficients. This comparison needs to
be made to determine if stormwater detention is
required.
2. Provide specification requirements for compacted
fill. These requirements will have an impact on
foundation design parameters.
3. Provide a sewer profile. This profile should be
coordinated with the design of the sand filter.
A copy of the sand filter design should be
submitted to this office in addition to the Health
Department.
4. Extend erosion control to include sand filter
excavation.
5. Use minimum radius of 5' rather than 3' as shown
in parking area curbing.
9 North Loudoun St. - P.O. Box 601 -
Winchester, Virginia
- 22601
SITE PLAN
PAGE 2 OF 2
6. Specify stone requirements, gradation and
compaction, for base course.
Signature: i _ __ __•__ _ ___
Harvey E. S wsnyd r, Jr., P.E
Director of Engine ing
0
•
COUNTY OF FREDERICK, VIRGINIA
FIRE MARSHAL'S OFFICE
LAND DEVELOPMENT COMMENTS
Control No, 041291348 Date Received 041291 Date Reviewed �42d�i
Applicant Name David E. McClure
Address 21 S. Cameron Street
Winchester, VA 22601
Project Name Liberty Baptist Church
Phone No. 703-722-4622
Type of Application Current zoning ,
1st Due Fire Co. _� 1st Due Rescue Co.
Election District /-
RECOMMENDATIONS
Automatic Sprinkler System
Automatic Fire Alarm System k
Emergency Vehicle Access;
Residential Sprinkler System
Other
Adequate X Inadequate Not Identified _
Fire Lanes Required; Yes x No
Comments:
wx/-p
Roadway/Aisleway Widths;
Adequate x Inadequate Not Identified _
Special Hazards Noted; Yes No X
Comments:
- Continued -
COUNTY of FREDERICI
Department of Planning* and Developmen
703 665-56f,
/ REQUEST FOR SITE PLAN COMMENTS FAX 03 667-03,
5
/Frederick -Winchester Health Department
P.O. Box 2056, Winchester, Virginia 22601
(703) 667-9747
The Frederick -Winchester Health Department is located at the
intersection of Smithfield Avenue and Brick Kiln Road, if you
prefer to hand deliver this review form.
Y°(� �u-
Applicant's name, address and phone number:
Name of development and/or description of the request:
Health Department Comments:
I.�f,(i / e-rt/1 P,,"/I 4WA*, J -d-f fl/1.',f i l
3i -
Health Signature and Date:
(NOTICE TO HEALTH DEPT-. - P
D15 @ R 0 V L5
It is you It
'i9osni
pleast
�.� "Y
E AETURN T S FO TO PLICANT.)
NOTICE TO APPLICANT
3ponsibility to complete this form as accurately as
c*der to -assist the agency with their review. Also,
a copy of your plans and/or application form.
`) Court <t:uare
P.O. Box 601 %Vinchestcr, Virginia - 1,1601
D (��IEDWR -
t v 1991 COUNTY of FREDER1Ch
00 1� h 's rtment of Planning and Development
703 665-56rt
L FAX 703 667-037i
REQUEST FOR SITE PLAN COMMENTS
/Frederick County Sanitation Authority
P.O. Boa 618, Winchester, Virginia 22601
(703) 665-5690
The Frederick County Sanitation Authority is located on the
second floor of the Old Frederick County Courthouse in
Winchester, if you prefer to hand deliver this review form.
-Appli ant's name, address and phone.number:
t.
a6 2
,,Name of develo ent and/or escrip ion of the request:
Sanitation Authority Comments:
/RST fi'FV/Fw W".'T,ER evyey //5-
Al--'Ad -ra *'we w 5/Af' o.0 �� T,rA .?5 dR �
11 iz;kr / Ce2°Z 435Z 4 F' 1,1WE PA14-1T A6Y TPA63- hiPA .2 i 9/
Sanit. Signature & Date:
(NOTICE TO SANITATION y
A�K4�MtOj"
��PL�ICAN�T)
EASE RETURN THIS
NOTICE TO APPLICANT
It is your responsibility to complete this form as accurately as
possible in order to --ass ist the agency with their review. Also,
please attach -r,40 —copies of your plans and/or application ::orm.