HomeMy WebLinkAbout23-07 U.A.G. Commonwealth Expansion of Auto Sales - Shawnee - BackfilePlease note: The site plans associated with this file are
located in the file room.
SITE PLAN TRACKING SHEET
Date:
3 File opened
Reference Manual updated/number assigned
3 D-base updated
3 D given to Renee' to update Application Action Summary
CLOSE OUT FILE:
��3 0'l Approval (or denial) letter mailed to applicant/copy made for file
(a l 07 File stamped "approved", "denied" or "withdrawn"
(o D7 Reference Manual updated
�O&,-07 D-base updated
4491
File given to Renee' for final update to Application Action Summary
RU---
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U:\Bcv\Common\Tracking shcns`Si c Plan Tracking wpd
P,cv scd 02/07133
(-I I �-1 5 (o
SITE PLAN APPLICATION CHECKLIST
The checklist shown below speci5es the information which is required to be submitted as part of the site plan
application. The Department of Planning & Dn elopment will reN iew the application to ensure that it is
complete prior to accepting it. If any portion of the application is not complete, it will be returned to the
applicant(s).
(1) One (1) set of approved comment sheets are required from eacb relevant review
agency prior to final approval of a site plan_ It is recommended that applicants
contact the Departmmt of Planning & Development to determine which review
agencies' are relevant to their site plan application. A list of potentially relevant
review agencies is shown below:
Frederick County Department of Planning & Development
�i Department of GIS (Geographic Information Services)
✓ Frederkh County Sanitation Authority
�- Frederick County Building Inspections Department
►-1 Frederick County Department of Public Wmlrs
Frederick County Fire Marshal
X Frfflzrich County Health Department
�— Frederick County Department of Parks & Recreation
X. Virginia Department of Transportation (VDOT)
City of VFmchester
Town. of Stephens City
_ Town of Middletown
_ Frederick County / Winchester Airport Authority
(2) One (1) copy of the Site Plan application form.
(3) Payment of the site plan review fee.
(4) One (1) reproducible copy of the Site Plan (if required).
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RECEIVED FROM II
ADDRESS I IC.z
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❑FOR RENT
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AMT.OF
CASH
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CHECK
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BALANCE
MONEY
DUE
ORDER
Page 1 of 2
Mark Cheran
From: Funkhouser, Rhonda [Rhonda.Funkhouser@VDOT.Virginia.gov] on behalf of Ingram, Lloyd
[Lloyd.ingram@VDOT.Virginia.gov]
Sent: Friday, June 08, 2007 8:40 AM
To: Mike Artz
Cc: Baluch, Stephen; Ingram, Lloyd; mcheran@co.frederick.va.us
Subject: UAG Commonwealth - Route 1167, Frederick County - VDOT Approval
This is to acknowledge receipt of your revised plans with latest revisions dated 5/31/07 for the
referenced project. The plans appear satisfactory and are approved, subject to the following
revision: On sheet 3, use the attached specification for 'Square Tube Steel Sign Posts' for the
STOP sign mounting post (rather than the sign detail shown for street signs).
Please advise the developer accordingly of this approval. Please provide 5 sets of
approved construction plans with signed seal for VDOT distribution.
I offer the following comments:
• A preconstruction conference be held by the engineer and/or developer with the
attendance of the contractor, various County agencies and VDOT prior to initiation of work.
• Materials used and method of construction shall apply to current observed VDOT Road &
Bridge Specifications applicable during construction of this development.
• Our review and comments are general in nature. Should conditions in the field exist such
that additional measures are warranted, such measures shall be completed to the
satisfaction of the Department.
• All drainage is to be carried within the right-of-way in ditch lines or gutters along the street
to a pipe or drainage easement.
• The contractor shall notify VDOT when work is to begin or cease for any undetermined
length of time. VDOT will also require 48 hours notice for inspections.
• The appropriate land use permits shall be obtained before any work is performed on the
State's right-of-way, e.g. signs and pavement markings. The permit is issued by this office
and will require a minimum processing fee, surety bond coverage, and the salary &
expenses of a State assigned Inspector.
• Any signs to be installed will be in accordance with the Manual on Uniform Traffic Control
Devices (MUTCD), 3rd Edition, and the approved plans.
If there are any questions, do not hesitate to contact me, or Mr. Stephen Baluch in the
Winchester Office at 540-535-1829.
6/2 l /2007
•
Page 2 of 2
Lloyd A. Ingram
Transportation Engineer
VDOT N Edinburg Residency
Land Development
14031 Old Valley Pike
Edinburg, VA 22824
(540) 984-5611
(540) 984-5607 (fax)
6/21 /2007
O TY c�f FREDERICK
Department of Planning and Development
540/665-5651
FAX: 540/ 665-6395
June 12, 2007
Mr. Mike Artz
Artz and Associates, PLC
16 East Piccadilly Street
Winchester, Virginia 22601
Re: Approval of Site Plan #23-07; U.A.G. Commonwealth
Property Identification Numbe►• (PIN): 75-A-91I
Dear Mike:
The above -referenced site plan was approved on June 12, 2007. The site plan is approved for the expansion of the
existing Ultimate Automotive Group facility located on Commonwealth Court in the Shawnee Magisterial District.
Required site improvements consist of the following:
A 2,400sf building expansion (three bays).
Revision of the parking lot to increase the landscaped area and the addition of five parking spaces.
Additional landscaping as indicated on the plan.
I am providing you with four (4) copies of the approved site plan. Please forward these copies to the appropriate
representative(s). Furthermore, advise the owners) that a copy should be kept for future reference, and an
approved copy must be kept on the construction site throughout the development process. Once site development
is complete, the owners) should contact this office to schedule an on -site inspection. Do not hesitate to contact me
if you have any questions or concerns.
Sincerely,
Cam' �'Cic� ��L-�l� •'`.
Candice E. Perkins
Planner Il
CEP/bad
Attachments
cc: Jane Anderson, Real Estate
Gene Fisher, Shawnee District Supervisor
June Wilmot and Robert Morris, Shawnee District Planning Commissioners
UAG Commonwealth, 201 Commonwealth COurt, Winchester, VA 22602
Commissioner of Revenue
107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000
AR'1 Z & ASSOCIA'I'I3S, PLC
16 Fast Piccadilly St.
Winchester, VA
22601
(540) 667-3233 (540) 667-9188 FAX
MEMORANDUM
TO: CANDICH, I?. PIsRKINS
PLANNER II
FROM: A1IANDA I.IG1 ITNL:It n AR17, & ASSOC.
SUBJECT: UAG COINIhfONW]"AlAl I; #23-07
DATE: 6/ 11 /2007
CC:
Dear Candice,
Bnclosed for your final review and approval is the final UAG Commonwealth Site Plan-
#23-07.
I have included 7 copies of the final Site Plan, as well as the approval sheets for the below listed
County Agencies:
A. Frederick County Inspections
B. Frederick County Fire Marshal
C. Frederick County Sanitation Authority
D. Frederick County Department of Public Works
E. Virginia Department of Transportation.
Should you have any questions or concerns you may contact me at the phone number or
address above you tllay also contact rile by e-mail at amandalitrhtner (t.conicast.net .
Thank you,
5mWin da �Ik
Request for Site9lan Comments
Frederick County Inspections Department
Mail To: Hand Deliver To:
Frederick County Inspecti Dff"JVID Frederick County Inspections Department
Attention: Building Official J Attention: Building Official
107 North Kent Street 107 North Kent Street, Fourth Floor
Winchester, Virginia 2260 FPR 9 h 2607 Winchester, Virginia 22601
(540) 665-5650 rornrp ry P--"j IC540) 665-5650
Applicant: Please fill out the information as accurately as possible in order to assist the agency
with their review. Please attach one (1) copies of the site plan with this sheet.
Applicant's Name: Artz & Associates, PLC Telephone
Mailing Address: 16 E. Piccadilly St. ; Winchester, VA 22601
540-667-3233
Name of development and/or description of the request: Minor Site Plan
U.A.G Commonwealth ; R&P Rentals (Ultimate Auto Group)
Location of property: . TM#75-A-911
201 Commonwealth Court; Winchester, VA 22602
Inspection Department comments:
INSPECTION DEPARTMENT USE ONLY
Date received
Incomplete a b
Date reviewed
Signature / Date
Signature / Date i
Date revision received
Incomplete
Date reviewed
' ram. ," .!k �y � 5 a ✓ c°' on 7�-P
Date approved 4z,
/
• •
tV
viz
Control number
SP07-0013
Project Name
R&P Rentals (Ultimate Auto Group)
Address
16 E. Piccadilly St.
Type Application
Site Plan
Current Zoning
B3
Automatic Sprinkler System
Yes
Other recommendation
Emergency Vehicle Access
Adequate
Siamese Location
Not Identified
2/26/2007
City
Winchester
Tax ID Number
75-A-91 1
Emergency Vehicle Access Comments
Access Comments
Additional Comments
Plan Approval Recommended
Yes
2/26/2007
Applicant
Artz & Associates
State Zip
VA 22601
Fire District
11
Recommendations
Automatic Fire Alarm System
Yes
Hydrant Location
Adequate
Roadway/Aisleway Width
Adequate
Applicant Phone
540-667-3233
Rescue District
11
Election District
Shawnee
Residential Sprinkler System
No
Fire Lane Required
Yes
Special Hazards
No
r3 /r, if
• �r
Reviewed By Signature ..�
Title FHaa. '.3T y �J `� r
Reauest for Site Pan Comments
Frederick County Sanitation Authority
Mail To:
Frederick County Sanitation Authority
Attention: Engineer Director
P.O. Box 1877
Winchester, Virginia 22604
(540) 868-1061
Hand Deliver To:
Frederick County Sanitation Authority
315 Tasker Road
Stephens City, Virginia
(540) 868-1061
Applicant: Please fill out the information as accurately as possible in order to assist the agency
with their review. Please attach two (2) copies of the site plan with this sheet.
Applicant's Name: Artz & Associates, PLC Telephone:
Mailing Address: 16 E. Piccadilly St. ; Winchester, VA 22601
540-667-3233
Name of development and/or description of the request: Minor Site Plan
U.A.G Commonwealth ; R&P Rentals (Ultimate Auto Gro
Location of property: TM#75-A-911
201 Commonwealth Court; Winchester, VA 22602
Frederick County Sanitation Authority comments:
i
z7z / 51 4 0 &1: � 7-- /��� AiY / e <>- //1-<
SANITATION AUTHORITY USE ONLY
Date received
Incomplete
Date reviewed
Signature / Date 4
Signature / Date
Date revision received
Incomplete
Date reviewed
Date approved
a
9 •
COUNTY of FREDERICK
Department of Public Works
540/ 665-5643
FAX: 540/678-0682
March 15, 2007
Mr. Michael M. Artz
Artz & Associates, PLC
16 East Piccadilly Street
Winchester, VA 22601
RE: Site Plan Comments- U.A.G. Commonwealth - R&P Rentals
Frederick County, Virginia
Dear Mr. Artz:
Upon review of the site plan received February 26, 2007, we offer no continents at this
time. Therefore, we recommend our approval of the subject site plan. Since the project proposes
to disturb less than 10,000 square feet, the proposed improvements will not require a Land
Disturbance Permit; however, all Erosion and Sediment control measures shall be in place as
shown on the proposed plans.
Sincerely,
Joe C. Wilder
Deputy Director
JCW/mlr
cc: Planning and Development
file
C:\Documents and Settings\i\IffiNly Doc umen ts\Review Formals\R&PRCN'rALS.wpd
107 North Kent Street • Winchester, Virginia 22601-5000
UAG Com n4alth - Route 1167, Freder* County - VDOT Approval •
Subject: UAG Commonwealth - Route 1167, Frederick County - VDOT Approval
From: "Ingram, Lloyd"<Lloyd.Ingram@VDOT.Virginia. gov>
Date: Fri, 8 Jun 2007 08:39:58 -0400
To: "Mike Artz" <mikeartz@adelplua.net>
CC: 'Baluch, Stephen" <Stephen.Baluch@VDOT.Virginia.gov>, "Ingram, Lloyd"
<Lloyd.Ingram @VDOT. Virginia.gov>, <mcheran@co.frederick.va.us>
This is to acknowledge receipt of your revised plans with latest revisions dated 5/31/07 for the
referenced project. The plans appear satisfactory and are approved, subject to the following
revision: On sheet 3, use the attached specification for 'Square Tube Steel Sign Posts' for the
STOP sign mounting post (rather than the sign detail shown for street signs).
Please advise the developer accordingly of this approval. Please provide 5 sets of
approved construction plans with signed seal for VDOT distribution.
I offer the following comments:
A preconstruction conference be held by the engineer and/or developer with the
attendance of the contractor, various County agencies and VDOT prior to initiation of work.
Materials used and method of construction shall apply to current observed VDOT Road &
Bridge Specifications applicable during construction of this development.
Our review and comments are general in nature. Should conditions in the field exist such
that additional measures are warranted, such measures shall be completed to the
satisfaction of the Department.
All drainage is to be carried within the right-of-way in ditch lines or gutters along the street
to a pipe or drainage easement.
The contractor shall notify VDOT when work is to begin or cease for any undetermined
length of time. VDOT will also require 48 hours notice for inspections.
The appropriate land use permits shall be obtained before any work is performed on the
State's right-of-way, e.g. signs and pavement markings. The permit is issued by this office
and will require a minimum processing fee, surety bond coverage, and the salary &
expenses of a State assigned Inspector.
Any signs to be installed will be in accordance with the Manual on Uniform Traffic Control
Devices (MUTCD), 3rd Edition, and the approved plans.
If there are any questions, do not hesitate to contact me, or Mr. Stephen Baluch in the
Winchester Office at 540-535-1829.
Lloyd A. Ingram
1 of 2
6/8/2007 2:01 PM
`ARTZ & ASSOCLATES�kC
A Subsidiary of
VALLEY ENGINEERING -SURVEYING -PLANNING
16 East Piccadilly St. • Winchester, VA 22601-4824
540-667-3233 • Fax 540-667-9188 • Toll Free 1-800-755-7320
April 11, 2007
To: Candice E. Perkins
Planner II
Department of Planning & Development
RE: U.A.G. (Ultimate Auto Group); The MLR Companies, LLC
Dear Candice:
Please find attached I set of the Revised plan that address the Review Comments Dated
3/26/2007. I have addressed each comment individually as follows:
1. Attached
2. Parking calculations have revised to reflect both existing and proposed structures.
3. Revised parking calculations require 2 HC spaces.
4. There is to be no outdoor storage of inoperable vehicles at any time on this site.
A note has been added to plan.
5. Island provided where requested. The existing Islands are being modified to meet
required green space.
6. Spaces have been delineated as to parking or display. 3' Evergreen hedge added
along adjoining property lines where required. Landscape calculations and plant
schedule have been provided.
If there are any questions or concerns, please contact me at your convenience.
Sincerely,
Michael M. Artz, L.S
A P R 2 4 2007
Special Limited Poiver of Attoriiey
C'ount-,- of Frederick,
Planning Office. County of Frederick, Virginii,107 \orth Bent Sneer. Wincllmtet
Phone 540-665-5651
Facsimile 540-665-6395
Know All Men By These Presents
(Name) M �-- �. Cc' �" �" ; cf�S, (-Q(- (Telephone)
(Address) 1 `3 C,., r-,,`r`-` Uc-\ �,� C?G= \ 0 T
the owners) of all those tract or parcels of land ("Property) conveyed to me (us), by deed recorded in the Clerk's Office of
the Circuit Court of the County of Frederick, Virginia by
Parcel: Lot: Blc
do hereby make , constitute and appoint:
(Name) 1/4 l� �ft ��i �f/G � (Phone)
(Address) /(0
To act as my true and Lawful attorney -in -fact for and in my (our) name, place and stead with full power and authority
I (we) would have if acting personally to file planning application for my (our) above described Property, including:
Rezoning (including proffers)
Master development plan (preliminary and final)
My attorney -in -fact shall have the authority to offer proffered conditions and to make amendments to previously
Approved proffered conditions except as follows:
This authorization hall expire one year from the day it is signed, or until it is otherwise rescinded or modrtied
In witness there f, I (we) 1)dv� hereto set m 1ir)-hand and seal this I() day of fkYi L , 200_Z_,
State of Virginia, City/ County of 0 V4 C t(-- , To -wit:
I, (tricC i urnbU_/Ia Notary Public in and for the jurisdiction aforesaid, certify that the person(s) whc signed to the
foregoing g instrument and who is (are) know to me, personally appeared before me and has acknowledge the same before me
in the jurisdiction aforesaid this 10 day of L , 200_�?'.
My commission Expires:
Notary Public
OARTZ & ASSOCIATES, *-C
A Subsidiary of
VALLEY ENGINEERING -SURVEYING- PLANNING
16 East Piccadilly St. • Winchester, VA 22601-4824
540-667-3233 • Fax 540-667-9188 • Toll Free 1-800-755-7320
May 2, 2007
To: Candice E. Perkins
Planner Il
Department of Planning & Development
RE: U.A.G. (Ultimate Auto Group); The MLR Companies, LLC
Dear Candice:
Enclosed is a revised site plan for U.A.G. Commonwealth; The MLR Companies, LLC.
Please replace this current Site Plan with this Plan dated 4/11/07.
Should you have any questions please don't hesitate to contact the office.
Sill ely,
Amanda K. Lightner
MAY 2 2007
COUNTY of FREDERICK
Department of Planning and Development
540/665-5651
FAX: 540/ 665-6395
April 3, 2007
Mr. Mike Artz
Artz and Associates, PLC
16 East Piccadilly Street
Winchester, Virginia 22601
Re: Review Comments for Site Plan #23-07; U.A.G. Conunonwealth
Property Identification Number (PIN): 75-A-91I
Dear Mike:
Planning Staff has reviewed the above -referenced site plan to determine if administrative approval can be
granted. At this time, administrative approval cannot be granted. This site plan is denied until the issues in
this letter, as well as all issues of the other review agencies, have been adequately addressed. Please review
Staff=s comments listed below and then prepare a revised site plan which adequately addresses each concern.
Review Comments:
1) Special Limited Power of Attorney Form. Plcase have the property owner sign the attached Special
Limited Power of Attorney Form prior to further review or approval. This form should be notarized
and completed to grant the applicant (you) with authorization to represent them for this site plan.
2) Parking Calculations. Only 500sf of the 3,800sf structure is being accounted for; the remaining
3,300sf needs to be parked at 1 /400sf.
3) Handicap ParkinIz. The site plan states that two I -IC spaces are required, 67 spaces requires three
I -IC spaces.
4) Outdoor Storage. Indicate if any area is needed to screen vehicles waiting to be repaired; if not
provide a statement that inoperable vehicles are not permitted to be stored at this site.
5) Parkin.- Lot Islands. An island needs to be provided at the end of the parking bay along the side of
the property as indicated on sheet 3. Also, please clarify why the interior islands are being modified
to remove existing parking spaces.
6) Landscaping. Delineate which spaces are display and which are office/service bay related; the
parking spaces associated with these uses need to be screened appropriately since they are not part of
the display spaces. Landscaping calculations need to be provided on the coversheet of the site plan
(total impervious surface, interior green space etc) and the types of plants need to be listed on the
landscaping plan.
107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000
r
6
0
Arts and Associates, PLC
RE: Site Plan #23-07
April 3, 2007
Page 2
After you have revised the site plan, please resubmit one copy so that I may verify the information contained
on the plan. I will need all approved review agency comment sheets and at least five copies of the final plan
for approval. Comment sheets are required from the following agencies: the Frederick Co1m1y Inspections
Department, 1he Frederi, .'ounty Fire Marshal, the Frederick Cowmty Sa111tallon Authorltj), and the Virginia
Department of Tranaporlcltion.
Do not hesitate to contact me if you have any questions or concerns regarding this letter.
Sincerely,
Candice E. Perkins
Planner lI
CEP/dlw
Attachment
cc: UAG Commonwealth, 201 Commonwealth COLII-t, Winchester, VA 22602
SITE PLAN APPLICATION
DEPARTMENT OF PLANNING AND DEVELOPMENT USE ONLY.
Date application received: 3 /,� `7 o Application #:
Complete Date of Acceptance:
Incomplete Date of Return:
1. Project Title: U.A. G. Commonwealth (R & P Rentals -Ultimate
Auto Group)
2. Location of Property: 201 Commonwealth Ct.
(street address) Winchester, VA 2602
3. Property Owner: R&P Rentals (Ultimate Auto Grou
Address: 201 Common Wealth Ct.
Winchester, VA 22602
Telephone: ( 540 ) 868-1300
4. Applicant / Agent: Artz & Associates, PLC
Address: 16 E. Piccadilly St.
Winchester, VA 22601
Telephone ( 540 )667-3233
5. Designer: Artz & Associates, PLC
Address: 16 E. Piccadilly St.
Winchester, VA 22602
Telephone: ( 540 )667-3233
Contact: Michael M. Artz, L.S.
•
6a
6b
7a
7b
8.
a.
b.
C.
d.
e.
f.
0
Is this a standard or 'minor' site plan?
Is this an original or revised site plan?
Total acreage of parcel to be developed
Total acreage of parcel:
Property information:
Property Identification Number:
Current Zoning:
Present Use:
Proposed Use:
Adjoining Property:
Adjoining Property Identification
Number(s):
Magisterial District(s):
Standard ✓ Minor
Original ✓ Revised
1.31 ac
1.31 ac
TM# 75-A-911
B3
Auto Sales & service
Expansion of above
Ventures of Winchester, LLC
H P Hood INC
TM#75-A-91 B
TM#63-A-86A
Shawnee Magisterial District
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
required material will be complete prior to the submission of my site plan.
Signature: 42so�
Date: 3f2(p - 67
�'�• � 'L� fir; .
COUNTY —or'- FR_EDFRP_
Department of' Puhlic AA'(,
540/ 6,65
FA\: 5•40/678-t'
March 15, 2007
N14r. iMichael M. Artz
Artz, & Associates. PLC
16 1'last Piccadilly Street
\1'inchester. VA 22601
RE: Site Plan Comments - U.A.G. Commonwealth - RLT Rentals
Frcdcrick County, Virginia
Dear N/Ir. Artz:
Upon review of the site plan received February 26, 2007, we offer no comments at this
time. I hel'cf01'e, \vc recommend Otll' 11)1)1'OV ll Of tllC SUblect Site plan. Since the project proposes
to disturb less than 10,000 square feet, the proposed inlprovements will not require a Land
Disturhancc Permit; however, all 1_;rosion and Sediment control Il1CaSLIl'CS Shall be Ill plaCC aS
Shown oil the proposed plans.
Sincerely,
Joe C. \Vi Ider
Deputy Director
JCW/nllr
cc: Planning and Development
file
C:Mocumenis and Scttinps\NIR\,Nl} Documents\Revie PormalsUt&I'RI?N'I' \I,S.wpd
107 North Kent Street • Winchester, Virginia 22601-500()
• •
Request for Site Plan Comments
Department of Planning and Development
Mail To:
Department of Planning and Development
Attention: County Planner
107 North Kent Street
Winchester, Virginia 22601
(540) 665-5651
Hand Deliver To:
Department of Planning and Development
Attention: County Planner
107 North Kent Street, Fourth Floor
Winchester, Virginia 22601
(540) 665-5651
Applicant: Please fill out the information as accurately as possible in order to assist the agency
with their review. Please attach two (2) copies of the site plan with this sheet.
Applicant's Name:
Mailing Address
Artz & Associates, PLC Telephone:
16 E. Piccadillv St. ; Winchester, VA 22601
540-667-3233
Name of development and/or description of the request: Minor Site Plan
U.A.G Commonwealth ; R&P Rentals (Ultimate Auto Grou
Location of property:
TM#75-A-911
201 Commonwealth Court; Winchester, VA 22602
Planning and Development comments:
PLANNING AND DEVELOPMENT USE ONLY
Date received
Incomplete
Date reviewed
Signature / Date
Signature / Date
Date revision received
Incomplete
Date reviewed
`0 2
Date approved
r
P,,IAR 2 6 2007
Document Approval Form
PLEASE REVIEW THE ATTACHED DOCUMENT. IF THIS DOCUMENT MEETS YOUR
APPROVAL PLEASE INITIAL AND PROVIDE THE DATE AND TIME OF YOUR
APPROVAL.
IF THIS DOCUMENT DOES NOTMEET YOUR APPROVAL PLEASE PROVIDE
COAIIENTSAS TO WHAT YOU WOULD LIKE TO HAVE COMPLETED.
INITIALS
DATE & 11M
Candice,
Bernie
Mark
Susan
Eric
Mike
Kevin
John
Lauren
COMMENTS:
Received by Clerical Staff (Date & Time):
U:\Pam\Common\Document Approval Form.wpd