HomeMy WebLinkAbout013-95 Church of Christ at Mt. View - Back Creek - Backfile* 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;
- 0K- slggs� VDOT
10K- 414 19 S ✓ Sanitation Authority
1K- +11'7lg5 Inspections Dept.
OK- Gtl�?lq ✓ Fire Marshal
-OK- 512+hs✓ County Engineer
Airport Authority
_�_ 2. One copy of the Site Plan application.
3. Five copies of the Site Plan.
5- 4. One reproducible copy of the Site Plan (if required).
5. One 35mm. slide of the Site Plan (if required).
TRACKING
Date
5 3 Application received.
All necessary agency comments received.
S - Z Fee Paid (amount $ 1153.OU )
-:�,17 Site Plan to Planning Commission via bi-monthly.
Site Plan heard by Planning Commission (if required).
Revisions received (if required).
Date of approval.
fo added to a ,ette. 13gs
City of Winchester
Town of Stephens City
Town of Middletown
Health Dept.
Parks & Recreation
Soil & Water Conservation Dist.
'RECEIPT
M= 024491
AMOUNT DUE
AMOUNT PAID
$ k
BALANCE DUE
PAID BY
CASH
i
CHECK
0 OTHER
FREDERICK COUNTY DEPT. OF PLANNING AND DEVELOPMENT if
P. 0. BOX 601, 9 NORTH LOUDON ST.
WINCHESTLR, VIRGINIA 22601
DA"--
RECEIVED FROM ` -h `, -� c l \t .
t ■ A.- - ,�,_.�Lk
00 RS =
MFRS RF '--L!FA N — G..—n :,SSA
COUNTY of FREDERICK
Department of Planning and Development
703i665 5651
FAX 703i678-0682
June 12, 1995
Church of Christ at Mountain View
Attn: Terry Bishop
P.O Box 2702
Winchester, VA 22604
RE: Church of Christ at Mountain View Addition Site Plan Approval
Dear Mr. Bishop:
The Frederick County Planning Department administratively approved Site Plan #013-95 for the
Church of Christ at Mountain View on June 9, 1995. The approved site plan calls for the
construction of a new gymnasium and school addition that will be 18,125 square feet, the
creation of a new asphalt parking lot that will contain 10 regular parking spaces, a future paved
parking lot that will contain 14 regular spaces, the provision of a paved lane for day care drop
off and bus access, the relocation of eight disabled parking spaces with appropriate signage, the
provision of concrete sidewalks to provide access from the parking lot to the building, the
installation of a fire hydrant and a fire lane access drive that will be 20 feet in width, and all
appropriate erosion and sedimentation control measures.
I have provided you with two copies of the approved site plan. This will allow you to maintain
an on -site copy and provide the church a copy for their records. Please contact this office to
schedule an on -site inspection once all improvements are complete. Please contact me if I may
answer any questions regarding this letter.
Sincerely,
Evan A. Wyatt
Planner II
EAW
enclosure
cc: James L. Longerbeam, Back Creek District Supervisor
T. Roy Jennings, Frederick County Real Estate
Joe C. Wilder, Engineering Technician
Timothy G. Painter, P.E.
107 North Kent Street P.O. Box 601
Winchester, VA 22601 Winchester, VA 22604
SITE PLAN APPLICATION,��' �• 1�,
Complete the following application:
31.
DATE
APPLICATION
1• Development CH�,.c,N or CN.L�S1 ,,; f`�1o��rn�.► �,Lu `_�cNoc�flab,nGW
2 • Location of Property: ���, ;,�� cr- C.aa►s� �r �a:n►TA�.t J„_�;
(by street name) C-a8
3. Property
P Y Owner: T —�. CA�vu� �:F
Address:
i�. a
Telephone: g c°,(,I- Z.'44
4. Applicant/Agent: '��ti��,y CZ
Address: 2,4„
Telephone: t7 ( i> L. U Z- C:
5. Designer:
Address:
Telephone:
Contact: 'f� r1 7,�,,., ; ►"ti
6. Is this an original or revised Site Plan?
Original ✓ Revised
-5-
7. Total area of parcel to be developed: 2,`l.3iL4 Ac
1.15 A,- b 6(-
8. Property Information:
a) Property ID #:
b) Current Zoning:
c) Present Use:
d) Proposed Use:
e) Adjoining Property Zoning:
f) Adjoining Property Use:
g) Magisterial District:
ti
�A
� \ (3J� N.itSi
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: x�.
Date: �_ �_
COUNTY of FREDERICK
Department of Planning and Development
703/665-5651
FAX 703/678-0682
March 13, 1995
Timothy G. Painter, P.E.
24 East Piccadilly Street
Winchester, Virginia 22601
RE: Church of Christ at Mountain View Addition - Site Plan Review
TA)mr T:I^.:
I have had an opportunity to review the above referenced site plan received by our department
on February 28, 1995. The following information needs to be provided to our department prior
to final site plan approval:
Please revise the site plan to change the zoning of the Virginia Pride Fruit Packers, Inc.
tract from B-2 to B-3. Our tax maps indicated that this was B-2; however, we have
recently discovered that the zoning classification was incorrect.
2) Please advise the owners that it would be prudent to indicate the new location of the
existing dwelling at this time. The setback requirements for this structure will need to
comply with the current setback requirements for the RA, Rural Areas Zoning District.
3) It is my understanding that no new outdoor lighting fixtures, outdoor storage areas, or
outdoor trash receptacles are proposed. Therefore, please disregard the notations on the
applicant's checklist.
4) Please provide our department with the site plan application, the site plan review fee, all
approved review agency comments, and five copies of the final plan for approval.
I would like to take this opportunity to commend you on your efforts for this project. Your site
plan is the only design that I have reviewed in my six years with Frederick County that has been
suitable for approval on the first submission. I look forward to receiving future plans from you
that are of this quality.
Sincerely,
Evan I Wyatt, anner II
enclosure
cc: Frederick County Board of Supervisors
107 North Kent Street
Winchester, VA 22601
P.O. Box 601
Winchester, VA 22604
REQUEST FOR SITE PLAN COMMENTS A
J
Frederick County Department G
Attn: wan► W -T-r
l ,2h
P.O. Box 601
Winchester, Virginia 22601
(703) 665-5650
The Frederick County Inspections Department is located at 9 North
Loudoun St., 2nd Floor of the Hammon Building in Winchester, if you
prefer to hand deliver this review.
Applicant's name, address and phone number:
T��T►�y �, �pNTi--L r� 0o3) UU 15�s
Z4 F. ST c jr-sw-j,
Name of development and/or description of the request:
0HVZ-c,4 of C14Z1ST- A— MO Jr.Jn--)IM \,/i ,F"J
5cV100L G'��1►.i115�ur� ��D�Ti0rJ
Location:
yL M �l C �ucu�-► L< C-��rJy ruLF.
Inspection Department Comments:
Code Administrator Signature & Date:
I Z .
►�9 S
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 plans and/or application form.
-14-
M-r.
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9
0
COMMONWEALTH of VIRGINIA
DEPARTMENT OF TRANSPORTATION
14031 OLD VALLEY PIKE
DAVID R. GEHR PO BOX 278
COMMISSIONER EDINBURG, 22824.0278
September 28, 1995
Mr. Charles W. Doughty
c/o Church of Christ at Mountain View
P. O. Box 2702
Winchester, VA 22604
Dear Mr. Doughty:
JU110
l
+4 �
V � �
WILLIAM H. BUSHMAN, P. E.
RESIDENT ENGINEER
TEL (540) 984.5600
FAX (540)984.5607
I am writing in response to our recent telephone conversation and the letter
you sent me dated September 19th. You have also, apparently, sent an identical
letter to our Governor, the Honorable George Allen. Our telephone conversation and
this correspondence is related to the Department's requirement for a right -turn taper
to serve the entrance to vour church and the multiple use fellowship hall recently
constructed.
To reiterate what I indicated in our telephone conversation, and to confirm
here in writing to you, is the fact that we understand how the finances are with a
church and that funds are not always readilv accessible nor available for expenses
such as this entrance work.
Our position is that the entrance would be put under permit with the
understanding the work would be performed when it was financially possible Nvithin
the framework of our penmitting process. Ideally, this would be within one (1) vear
from the date the permit is issued.lf the time frame is going to expire before the
necessary funds can be accumulated to do the work, then %ve will work with the
church and extend the permit deadline appropriately to insure construction of the
entrance modifications.
Our one purpose in requiring anv kind of commercial entrance permit and its
features is of safety: for the users of the entrance and the users of the road the
entrance abuts. We are not asking your church to provide any more to your entrance
than is absolutelv, minimally necessary to provide adequate safety for the users of
vour entrances and the motorists of Route 1 1.
r
Mr. Charles W. Doughty
September 28, 1995
Page Two
We are committed to worldng with you and your congregation in providing an
adequate entrance for your church and its facilities.
1f our part of this is unclear, please let us know. We will be glad to meet with
You and members of your church community to fully explain what we are requesting
vour church to provide.
Sincerely,
William H. Bushman, P.E.
Transportation Resident Engineer
WHBAvcz
Cy: Mr. R. B. Childress
Mr. S. A. Melnikoff
Ja
COMMONWEALTH H of VIRCIhTLA
DEPARTMENT OF TRANSPORTATION
14031 OLD VALLEY PIKE
DAVID R. GEHR P.O. BOX 278 WILLIAM H. BUSHMAN, P.E.
COMMISSIONER EDINBURG, 22824.0278 RESIDENT ENGINEER
TELE(703)984.5600
PAX (703)984.5607
May 5, 1995
Mr. Timothy G. Painter, P.E. Ref: Mountain View Church of Christ
C/O Painter, Lewis & Associates Route 11
24 East Piccadilly Street Frederick County
Winchester, VA 22601
Dear Tim:
We have received your revised site plan dated April 21, 1995 for the referenced project.
It appears all of our previous review comments have been satisfactorily addressed.
Please advise the owners of our approval.
A land use permit may now be applied for to cover the required entrance improvements
within the Route 11 right-of-way. Said permit is issued by this office and will require a
processing fee and surety bond coverage. A permit of this nature may take approximately
thirty days to process and issue once satisfactory application has been made.
If you have any questions concerning the above, please let me know.
RBC/rf
Enclosure
xc: Mr. S. A. Melnikoff
Mr. R. W. Watkins
Sincerely,
William H. Bushman
Trans. Resident Engineer
By: Robert B. Childress
Trans. Permits & Subdivision
Specialist Supervisor
RD
A,
C
TRANSPORTATION FOR THE 21 ST CENTURY
W r,
REQUEST FOR SITE PLAN COMMENTS
Virginia Department of Transportation
Attn: 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 St. in Winchester if you prefer to hand deliver this
form. - - - - - —
Applicant's name, address and phone number:
24 E. \jA ZV-c=
Name of development and/or description of the request:
c-kUZL1A c�- C-V1 %ST Nr j lt�l; tlT(a Y.S viE,-j - /a1,t n o td
Location:
V VY'i1LPL\ ��Yr*.
S\tw1)lsl.t�.i.
LL:.
VN
M►�E r� �r�a o�
Q/�0..rC,N.
v� �-i..ii,
v ty �.5. ���
Nb � YIXL t.-14r TZ) t7 MJ
Va. Dept. of Transportation Comments:
See attached letter from W. H. Bushman to Mr. Tim Painter dated 05/05/95.
VDOT Signature and Date:6t /� C, .n / u .4G
(NOTICE TO RESIDENT ENGINEER*PLEASE RETLWTHIS FORM TO APPLICANT.
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 three copies of your plans and/or ap
r5 c 7_,
EDINBURG RESIDENCY
FEB 23 1995
- 10- U WHB ❑ JAG WLS C. KDW
51 REC 0 K S H KriC = RLF
0 VC7_ Conies to
COMMONWEALTH of VIRQINIA
DAVID R. GEHR
COMMiSS-ONEH
Mr. Tim Painter, P.E.
C/O Painter, Lewis & Associates
24 East Piccadilly Street
Winchester, VA 22601
Dear Tim:
DEPARTMENT OF TRANSPORTATION
14031 OLD VALLEY PIKE
PO BOX 278
EDINBURG,22824-0278
March 31, 1995
WILLIAM H. BUSHMAN, P.E.
RESIDENT ENGINEER
TELEI7031984.5600
FAX(7031984-5607
Ref: Mountain View Church of Christ
Route 11
Frederick County
As requested we have reviewed the above referenced project site plan dated January 25, 1995. Our
comments may be found on the enclosed plans marked in red and as follows:
1. The northern curb and gutter radius (Standard CG-7) will need to be removed and replaced to match
the proposed southern radius. Also, a standard 12' pavement offset from the edge of pavement to face
of gutter pan will be required.
2. A 150' taper will need to be provided on the southbound approach to the entrance. It appears this can
be accomplished with relatively little grading on the Route 11 right-of-way. Also a standard 36' taper
will need to be provided on the south side of the entrance.
3. A half typical section of the proposed entrance improvements will need to be added to the plan.
4. After the entrance widening and taper improvements occur the entire entrance will need to be overlaid
with 2" of Type SM-2A asphalt concrete.
5. In addition to the proposed pavement striping, appropriate signage will be required.
6. Existing sight distance, speed limit, and reference will need to be added to the plan.
7. The enclosed copy of our standard CG-7 curb & gutter specification will need to be incorporated into
the plan.
Please revise and resubmit six copies for final approval. Should any changes be deemed necessary, please
design them to meet or exceed the above recommendations.
If you have any questions or would like to discuss any of our comments, please let me know.
Sincerely,
Robert B. Childress � 77
Trans. Permits & Subdivision
Specialist Supervisor \ 1
RBC/rf
Enclosure
xc: Mr. S. A. Melnikofl; Mr. R. W. Watkins
TRANSPORTATION FOR THE 21ST CENTURY
r
COMMONWEALTH of VIRGINIA
DEPARTMENT OF TRANSPORTATION
14031 OLD VALLEY PIKE
DAVID R. GEHR PO. BOX 278
COMMISSIONER EDINBURG. 22824.0278
March 6, 1995
Mr. Tim Painter, P.E.
C/O Painter -Lewis & Associates
24 East Piccadilly Street
vvinchester, LEA 22601
Dear Tim:
�14 J 11
7 �1I
WILLIAM H. BUSHMAN, P.E.
RESIDENT ENGINEER
TELE17031984-5600
FAX (703)984.5607
Ref: Mountain View Church of Christ
Route 11
Frederick County
We have received your site plan dated January 25, 1995 for the referenced project. It has
been forwarded to our District Office in Staunton for review. Once we have received any
comments we will forward same to you. For your information a review of this nature
normally takes approximately sixty days.
In the meantime if you have any questions, please let me know.
RBC/rf
xc: Mr. S. A. Melnikoff
Mr. R. W. Watkins
Sincerely,
William H. Bushman
Trans. Resident Engineer
By: Robert B. Childress
Trans. Permits & Subdivision
Specialist Supervisor
TRANSPORTATION FOR THE 21 ST CENTURY
FROM FREDERICK CO. SANITF*"' AUTHORITY 06.07.1 08:11
REQUEST -FOR SITE _PljA i COMMEM
Frederiok county Sanitation Authority
Attn: Engineer Director
199 Front Royal pike
P.O. Box 618
Winchester, Virginia 22604
(703) 663-3690
rra�rt��r
�.0L.i r L-
The Fraderick county Sanitation Authority is located on U.S. 522
South, one tenth of a mile from the U.S. 50 North intersection, if
you prefer to hand deliver this review.
Applicant's name, address and phone numbe►rt.
Jr C, PjCrAo0,%--1 S,-MX vet t4gIL-&Tp, o�, t
Name of development and/or description of the requeett
4
C441je&tj C)f C�40-Jb,r 4T t�NorAvj Vif,.4
�
�
�
�
ri� a 6v�,MI���vM �Da� no►�
Location:
4-11 1fi�t�.�r1 �IK�
�o
i
NA L4' 1-w# Tu o F a'MM v, u..(,
Sanitation Authority Comments:
$7"' Re' V oFW -- L / rx,� C0�,t�'0
Wj MI-F-9901 .4 9�M - I --I
Sanitation Authority Signature & Date: .
(NOTION TO SANITATION AUTHORITY * RN THIS FORM TO APPLICANT.)
/14*4,V ;? fr
NOVICE 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.
,8y 7^Hv�fi J ak
Tr �r
***END***
• 0
REQUEST FOR SITE PLAN COMMENTS
Frederick County Inspections Department
Attn: Building Official
P.O. Box 601
Winchester, Virginia 22601
(703) 665-5650
The Frederick County Inspections Department is located at 9 North
Loudoun St. , 2nd Floor of the Hammon Building in Winchester, if you
prefer to hand deliver this review.
Applicant's name, address and phone number:
TM�T�ayc�u2 I5,.5
Name of development and/or description of the request:
Gf+V Z,G,4 C F C141z I s r ,a - Mc ►%J r7) , As \%j &,J
Location:
4 If
Inspection Department Comments: Building shall comply with Virginia Uniform
Statewide Building Code and Section 303, Use Group A (Assembly) for the Gym and
SPrtion 304Use Croup E (Educational) for the school of the BOCA National Building
Code/1993. Other codes that apply are title 24 Code of Federal Regulation, Part 36
Nnndicrrimination on the RasiS of Disahility by Public Accommodations and in
Commercial Facilities. NOTE: Demolition permit is required to remove Ex. Mobil
Tlnit Ana parkingpnrking shall have a min 8'-8' van accessible space Phase check
*A4.6 Page 35 679 ADA. .",/
Code Administrator Signature & Date: Z� � X���1ss
(NOTICE TO INSPECTIONS DEPT. *PLEASE�tETURN T M TO �'LI S FOR . )
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 plans and/or application �form._,�--
-14 - ;`�
0
0,
COUNTY CF FREDE==C , VIRGINiA
FIRE MARSHPL' S OFFICE
LAND DE',IELOFME JT COMMENTS
Control No. 0606952548 Data Recz i,ed 060695 Daze Re,/ i ewed 9S
Applicant Name _ Timothy G. Painter, P.E.
Address 24 E. Piccadilly Street
Winchester, er, VA 22601
Project Name Mt. View Church of Christ
Phone No. 703-662-1565
Tvpe of Application ✓/-22'-- pLgc/ Current Zoning
1st Due Fire Co. 1st Due Rescue Co. 1//
Election District
RC.COMMENDATIONE
Automatic Sprinkler System Residential Sprinkler System
Automatic Fire Alarm System A_ Other
Emergency Vehicle Acczss;
Acecuate �_ Inadequate Nct Identified
Fire Lanes Requ i rec ; Yes �_ No
Comments:
LOc�iT%D,(/S
Rcadwav/Aislewav Widt~s;
Adequate X I nadecua c` No z Iden t i f i ed
Special Hazures ,vo tzc ; Yes Nc
Comments:
- Ccnc:nuec -
11
COUNTY OF FREDERICK, VIRGINIA
FIRE MARSHAL'S OFFICE
LAND DEVELOPMENT COMMENTS
Control No. 0228952147 Date Received 022895 Date Reviewed 032395
Applicant Name Timothy G. Painter, P.E.
Address 24 E. Piccadilly Street
Winchester, VA 22601
Project Name Church of Christ at Mt. View
Phone No. 703-662-1565
Type of Application Site Plan Current Zoning RA
1st Due Fire Co. 11 1st Due Rescue Co. 11
Election District Back Creek
RECOMMENDATIONS
Automatic Sprinkler System X Residential Sprinkler System
Automatic Fire Alarm System X Other
Emergency Vehicle Access;
Adequate X Inadequate Not Identified
Fire Lanes Required; Yes X No
Comments Posted fire lanes required at all hydrant
locations and at F.D. siamese connection.
Roadway/Aisleway Widths;
Adequate X Inadequate
Special Hazards Noted; Yes
Not Identified
No X
Comments d
Continued =
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COUNTY of FREDERICK
Public Works Department
Harvey E. Strawsnyder, Jr., P.E.
Director
703/665-5643
Fax:703/678-0682
May 24, 1995
Mr. Timothy G. Painter, P.E.
Painter -Lewis and Associates
24 East Piccadilly Street
Winchester, Virginia 22601
RE: School and Gymnasium Addition
Church of Christ at Mountain View
Frederick County, Virginia
Dear Tim:
The site plan proposed for the school and gymnasium addition to
the Mountain View Church of Christ has adequately addressed
stormwater management and erosion and sediment control measures.
Therefore, we grant our approval for construction.
Sincerely,
oak�u� E. , ,P ,
Harvey E. Strawsnyder, Jr., P.E.
Director of Public Works
HES:rls
cc: Planning Department
file
107 North Kent Street P.O. Box 601
Winchester, VA 22601 Winchester, VA 22604
COUNTY of FREDERICK
i
Public Works Department
Harvey E. Strawsnyder, Jr., P.E.
Director
703/665-5643
Fax:703/678-0682
April 21, 1995
Mr. Terry Bishop
Valley Building Systems, Inc.
Front Royal Business Park
490-G South Commerce Avenue
Front Royal, Virginia 22630
RE: Land Disturbance Permit
Gymnasium and School Addition
Church of Christ at Mountain View
Frederick County, Virginia
Dear Mr. Bishop:
We have reviewed the subject erosion and sediment control plan
and offer no comments. Consequently, we recommend approval of the
subject land disturbance permit.
We request that you contact this office when phase one of the
erosion and sediment control is in place to schedule a site
inspection.
If you have any questions, do not hesitate to contact me.
JCW:rls
cc: file
Sincerely,
oe C. Wilder
Engineering Technician
Department of Public Works
107 North Kent Street
Winchester, VA 22601
P.O. Box 601
Winchester, VA 22604
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ISSUED TO:
LAND DISTURBING PERMIT
n I
who has met all requirements of the Frederick County Erosion and
Sedimentation Control Ordinance as certified by the Frederick
County Department of Public Works.
AGREEMENT
This agreement, made this �jl day of
19a� by and between
I
9
party(s) of the first part, and the County of Frederick , Virginia,
party of the second part.
Whereas, in consideration of the approval by the party of the
second part of this Virginia land disturbance plan and permit for
the Ox(f C h 4 Chru:)t ccl:� t"IC� I_. Cal ►'1 V V �_L
of I.� (actual disturbed acres)
and the party of the second part requiring the following work to be
completed during the land disturbance construction and before final
occupancy, the party(s) of the first part or his heirs/assigns
agree to do the following work:
1. Provide for the adequate control of erosion and sedimentation
by temporary and permanent control practices and measures
which will be implemented during all phases of clearing,
grading and construction and to provide for conformity with
the Virginia Erosion and Sediment Control Law, Title 21,
Chapter 1, Article 6.1 of the Code of Virginia and local code
laws.
2. To provide Erosion and Sediment Control as per the Erosion and
Sedimentation Control Plan.
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W=
The party (s) of the first part does further agree that an agent of
Frederick County shall be permitted entry to the site of the land
disturbing activity to inspect the control measures shown in the
approved plan.
In testimony whereof, the party of the first part has hereunto
caused its corporate names and seals to be hereunto affixed, for
and in its behalf, by
and caused this agreement to be acknowledged and delivered for and
in its behalf.
l
ORAT)ON
BY:
In testimony whereof, the party of the second part has hereunto
caused its body corporate names and seal to be hereunto affixed,
for and in its behalf by b-rle r L J
ounty of F ederick, Vir inia
BY: \
Freder' k County Dep rtm t of
Public Wrks
NOTE: Issuance of this permit does not constitute approval of
a site plan. This permit is for land disturbance only.
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-3-
STATE OF VIRGINIA
COUNTY OF FREDERICK
I,
, a Notary Public in
and for the State and County aforesaid, do hereby certify that this
day personally appeared before me in my said County,
(name) of (company)
and
of the Frederick' County Department of Public Works whose names are
signed to the foregoing agreement dated �� 1
did personally appear before me and acknowledged the same.
Given under my hand this 1ST day of (]LQy- k 1 ,
1�
Notary Public
My Commission expires on
L]
APPlication for Land Dluturbance Permit page 5
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DATE s = 9 PROJECT
PROPERTY OWNER:
TEL.MIONE:. 745�b(e-j
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TELEPHOHla t
PLAN DEMNERt4�
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MAGISTERIAL D16TRICT;
PROPERTY IDENTIFICATION NUMBZR:,.�.��
TCTAL ARF...A OF PROPERTY: *7d , ,s164 Ac.
"S'P ►G+S OF ARIaA TO 13E DISTMEDs 1,
ZOVING OF PROPERTY,
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