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HomeMy WebLinkAbout34-09 Galilee Christian Ch. - Fellowship Building - Gainesboro - BackfileSITE PLAN TRACKING SHEET Comment Sheets: GIS ✓ VDOT Winchester Sanitation Authority , Inspections ✓ Stephens City X — Public Works /_ Middletown Parks & Rec J_ Airport_ Health Dept. ✓ ✓ File V One copy of Site Plan application form V Payment of site plan review fee One reproducible copy of Site Plan OPEN FILE: He Opened 4kyc Reference Manual updated/number assigned Y D D-base updated CO/b r Application Action Summary updated CLOSE FILE: Approved (or denied) letter mailed to applicant/copy to file and cc's File stamped "approved", "denied" or "withdrawn" Reference Manual updated D-base updated 4--- 611 Application Action Summary updated 1 Sys ID # `�� O a� m N +� O Lo �. c3 N N o Ca C7 cn �,O p y N y Cal))V > °moCd gH� o u V � " 11 1111111 I V U � � � V7 RECEIVED FROM Cl FOR RENT ❑ FOR DATE 91 — 141- 0-1 aul_r Uv vl- 6 c 2t�n NO. 1220 VA zZ(Dy i ,0552 Vc AMT. OFN ACCOUNT ' CASH 3 A AMT. PAID '�" CHECK BALANCE MONEY DUE ORDER BYL� 0 COUNTY of FRE1DERICK Department of Planning and Development S40/665-5651 FAX: 540/ 665-6395 December 18, 2009 Mr. Scott Stickley, PE Pine I-Iills Engineering, PC P.O. Box 1168 Front Royal, Virginia 22630 RE: Approval of Site Plan 434-09; Galilee Christi:", Church Fellowship Building Property Identification Number (PIN): 32-A-44E Dear Scott: The above -referenced site plan was approved on December 17, 2009. The site plan is approved for the construction of a new 6,256 square foot Fellowship Building for the Galilee Christian Church located on Russell Road in the Stonewall Magisterial District. Required site improve►nents include the following: Construction of a parking lot with 50 spaces (including two handicap accessible), including wheelstops, striping and handicap access. One screened dumpster location, landscaping and lighting. All requirements of the Frederick County Zoning Ordinance have been met in the approved site plan, including review agency comments from all relevant review agencies. I am providing you with five (5) copies of the approved site plan. Please forward these copies to the appropriate representative(s). Furthermore, advise the owner(s) 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 owner(s) should contact this office to schedule an on -site inspection. Do not hesitate to contact me if you have any questions or concerns. Sincerely, Candice E. Perkins, AiCP Senior Planner Attachments CEP/bled cc: Jane Anderson, Real Estate Charles DeFlaven, Stonewall District Supervisor Gary Oates and Richard Ruckman, Stonewall District Planning Commissioners Commissioner of Revenue Trustees of Galilee Christian Church, 1931 Welltown Road, Clearbrook, VA 22624 107 North Kent Street, Suite 202 o Winchester, Virginia 22601-5000 • • Candice Perkins From: Scott Stickley [pinehills@embargmail.com] Sent: Friday, December 18, 2009 2:32 PM To: Candice Perkins Subject: Fwd: Galilee Christian Church - VDOT Plan Approved Attachments: SCN_20091105133543_001.pdf Sorry I forgot about this. Thanks for everything, have a great Christmas. Scott Stickley, P.E. Pine Hills Engineering, PC I'.O. Box 1168 Front Royal, VA 22630 (540) 622-3405 Mobile (540) 636-1709 Fax www.pinehilisen .corn ----- Forwarded Message ----- From: "Lloyd Ingrain"<Lloyd.Ingram@VDOT.virginia.gov> To: pinehills@embargmail.com Cc: "Lloyd Ingrain" <Lloyd.Ingram@VDOT.virginia.gov>, "Mattliew Smith, P.E." <Mattliew.Smith@vdot.virginia.gov>, "John.Bishop" <jbishop@co.frcdcrick.va.us> Sent: Thursday, November 5, 2009 1:37:36 PM GMT -05:00 US/Canada Eastern Subject: Galilee Christian Church - VDOT Plan Approved We have received your site plan dated September 8, 2009 for the subject project. The plans are approved with the addition of the following comment to the plan set: Add notation to the plans that the "On -Site Typical Pavement Section" is to be used on the proposed entrance off Route 686. Please provide four (4) sets of approved construction plans with signed seal for VDOT distribution. The appropriate land use permit may now be applied for to cover work within the Route 686 right- of-way. 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. Once satisfactory application has been made, a permit will normally take approximately thirty days to process and issue. Should you have any questions, do not hesitate to call. <<SCN 20091105133543_001.pdf>> Lloyd A. Ingrain, Transportation Engineer Virginia Department of Transportation Edin burg Residency — Land Development 14031 Old Valley Pike Edinburg, Virginia 22824 Phone #(540) 984-5611 Fax #(540) 984-5607 • • Candice Perkins From: Scott Stickley [pinehills@embargmail.com] Sent: Friday, December 11, 2009 12:43 PM To: Candice Perkins Subject: Re: Galilee Church Thanks for the quick review. The value at the property line is about .035-.040 based on the contours the program generated. The driveway for that residence has a value of .02 on it, where the existing 18" cmp culvert is. I will add a note for that specific light to be shielded as mentioned in your comment. I'm waiting to hear from Public Works but I believe all other agencies have approved their part of the plans. Do you want me to make the adjustment on the lighting and bring in sets signatures once I hear from Public Works? Scott Stickley, P.E. Pine Hills Engineering, PC P.O. Box 1168 Front Royal, VA 22630 (540) 622-3405 Mobile (540) 636-1709 Fax www.pinehillseng.com ----- Original Message ----- From: "Candice Perkins" <cperkins@co.frederick.va.us> To: pinehills@embargmail.com Sent: Friday, December 11, 2009 11:18:05 AM GMT -05:00 US/Canada Eastern Subject: Galilee Church Scott, Just reviewed the revise plan and have one additional comment on the lighting plan. The lighting levels at the western property line (adjoins a residential property) cannot exceed 0.2 foot-candles (appears to be closer to a 0.5 at the property line). This needs to be revised and that particular pole needs to be fitted with a supplemental opaque shield. Do you have all your agency approvals at this time? -Candice Candice Perkins, AICP Senior Planner Frederick County Department of Planning & Development 107 North Kent Street Winchester, Virginia 22601 (540) 665-5651 (540) 665-6395 (fax) cperkins@co.frederick.va.us www.co.frederick.va.us 1 • Candice Perkins From: Scott Stickley [pinehills@embargmail.com] Sent: Thursday, December 17, 2009 8:53 AM To: Candice Perkins Subject: Galilee FYI - I did receive the Public Works approval and have 7 sets along with the other agency approvals for final approval. Yesterday I delivered everything to Ms. Ilimelright for her and Scott Watts' signatures on each cover page. They should be dropping the sets off sometime today. Thanks. Scott Stickley, P.E. Pine Hills Engineering, PC P.O. Box 1168 Front Royal, VA 22630 (540) 622-3405 Mobile (540) 636-1709 Fax www.pinehillsengcom Request for Site Plan Comments Virginia Department of Transportation Mail to:Hand deliver to: Virginia Department of TransportationVirginia Department of Transportation Attn: Resident Engineer2275 Northwestern Pike 14031 Old Valley PikeWinchester, Virginia 22603 Edinburg, Virginia 22824(540) 535-1818 (540) 984-5600 Please fill out the information as accurately as possible in order to assist the Virginia Department of Transportation with their review. Please attach five (5) copies of the site plan !with traffic generation data and drainage calculations with this sheet. Applicant's Name: 6Rl NA Phone Number. Name of development and/or description of the request: via hQ LAI? 1u.-a Location of property: Virginia Department of Transportation's Comments: See attached VDOT approval dated November 5, 2009.. 1 VDOT use only Date received Date revision received Date approved Incomplete I: Incomplete Date reviewed. Signature and Date 11/05/09 Signature and Date revision) 13 L-J • V CO N'-ty, of -FREDERICK Departrrient of Public Works 540/665-5643 FAX. 540/678-068Z December 15 •200"0 Mr Scott Stickley, 11:E. Pine:Hills Engincefing, PC P G Box 116& Frorit'R6yal, Vii'ginia:22630' RE. Galilee Christian -Church — Proposdd Fe116�vship,Building — Revised Site•Plali Comments Frederick County. Virginia Dear Scott. We have cofnpl'eted our -review of the -revised site plan.dated'November A 2009 All,of our -previous comments have been addressed'. Therefore, we recommend approval -of the subject siteplaii. •Sirlcercly to Joe.C. Wilder Deputy Director of'Public Works JCW/rls Cc. -Panning and,development file TARIiondMTEIIIPCONINIENI'S\GALIL-EECIIRISTIANCIIURCnF CI;LOWSI IIIIBLUGREVSPCOALdoe r Request For Site Plan Comments Frederick County Inspections Department Mail to: Frederick County Inspections Dept. Attn: Building Official 107 North Kent Street Winchester, VA 22601 (540) 665-5650 Hand deliver to: 107 N. Kent Street, Suite 200 North Building, 2"d Floor Winchester, VA (540) 665-5650 Please fill out the information as accurately as possible in order to assist the agency with their review. Please attach one (1) copy of the site plan with this sheet. Applicant's Name: Address: Phone Number: Name of development and/or description of the request: Location of property: Inspections Department's Comments: Inspections Dept. use only „ Date received Date rev)sion/� eceived Incomplete Income ete/1 (/ Date reviewed Date r� ve wed Signature and Date Signature and Date (revision) 16 A!O b1 Date approved �� • Buildings shall comply with The Virginia Uniform Statewide Building Code and section 303 - A,Assembly Use Group of the International Building Code/2006. Other Code that applies is ICC/ANSI A117.1-03 Accessible and Usable Buildings and Facilities. Structural plans submitted for permit application shall be sealed by a Virginia Licensed Design Professional. Proposed 3200 sq ft Christian church with 3200 sq ft unf basement has area way and exits from both levels. All required egress shall be Handicap Accessible. Unfinished Basement shall meet ANSI Accessible requirements and be on an accessible route. Exterior route not provided on site plan at this time. Height and area shall be per T503 for A3 Use. Basement shall be considered `Story above grade' if more than 6' above grade plan. Site plan notes exits and I -IC parking, as well as grading per ANSI. Parking provided per TI 106.1 with on van accessible space as required. Signage shall be provided per USBC 1106.8. Please note the requirements in Chapter 17 of IBC for special inspection requirements on the type of structure.( Soils, concrete ect..). • Request For Site Plan Comments Frederick County -Winchester Health Department Mail to: Hand deliver to: Frederick -Winchester Health Department 107 North Kent Street, Suite 201 Attn: Sanitation Engineer Winchester, VA 107 North Kent Street, Suite 201 (540) 722-3480 Winchester, VA 22601 (540) 722-3480 Please fill out the information as accurately as possible in order to assist the agency with their review. Please attach one (1) copy of the site plan with this sheet. Applicant's Name: `1Z�}�(�.�� C$F CIIV LA,i _ C_11 _k,SJ Aj l /' 0(y- A4 Address: ����� U cVA �Iua2A Phone Number: Name of development and/or description of the request: -X MAP �Z�>✓k"` Location of property: I�f�110 t-J �lDNKI OADAND V4 l Health Dept's Comments :M0:5F %/rra.f �U� Cj��/ is�s��_ -_X; f S%>�,: ('i �. a i' U ��r L '/7 + Jz �-- _•_a' 14( (, 1C.L Ur 1 // L/S iJ � _ �/-f! .J-r.%_P !/'' 1'� a� !o,•s-(./r Health Dept. use only Date received �� Date revision received Incomplete Incomplete Date reviewed ,Z� v�( Dat reviewed Signature and Date Signature and Date (revision) 20 Date approved 0 1cx 0 A ti(` : `; AI N, C I .� VIRGINIA Fi•a,d(.;i-ici', G01,ln IV I'(-) a1-1 � i��(1ScttcI 0.1,1icc: F:ivc WN-"i's had, Plan {Zoview -III(,; C.Oi3iii ervi:G Control number Date received Date reviewed Date Revised s e 0 9 -00 2© 9/16/2009 9/17/2009 Project Name Applicant Galilee Christian Church -Fellowship Building Trustees of Galilee Christian Church Address City State Zip Applicant Phone 1831 Welltown Road Clearbrook VA 22624 Type Application Tax ID Number Fire District Rescue District Site Plan 32-A-44E 13 13 Current Zoning Election District RA Recommendations Stonewall Automatic Sprinkler System Automatic Fire Alarm System Residential Sprinkler System Yes Yes No Other recommendation Emergency Vehicle Access Adequate Siamese Location Not Identified Emergency Vehicle Access Comments Access Comments Additional Comments k1eq U06erflenI. Hydrant Location Fire Lane Required Not Identified No Roadway/Aisleway Width Special Hazards Adequate No Plan Approval Recommended Reviewed By Signature Yes J. Neal Title Rcqucst for Street Name Comments Site Plan Review Prccicricic County hi('ormation Technologies, GIS Division Attn: GIS \Manager 107 \North Kent Street «Vinchester VA 22601 540-665-5614 The GIS staff will review the proposal strcct names for this proicet to ensure that their acceptability into the Frederick County strcct name system. Please attach one copy of the plan indicating proposed street names. Applicant's Name: �IYTt ` AO" Address: W&,zlowN Phone: \Name of (levelop►nent and / or description of request: 7���•CJ��u, NNE gbN--tp"MV p{LICIM� Location of property: `P�1�ca�1 ai V�Is'Cowt�lj��'� dvo GIS Manager comments: Na c It oul oad—n fflcS 0're, roul,W The a(►cSS rff i OALA VRO( i i NJ I be I) o I k I ),�Sr, Date received Incomplete? _ Date First reviewed Date revision reviewed Date revision received Incomplete? q f ICP 10q Reviewed and signed by 1 Reviewed and signed by • ENGNE ILLS /NEEi?1NG. December 9. 2009 P.O. Box 1168 PC Front Royal, VA 22630 Mobile: (540) 622-3405 Fax: (540) 636-1709 Frederick County Department of Planning and Development Attn: Ms. Candice E. Perkins, AICP 107 North Kent Street, Suite 202 Winchester, VA 22601 RE. Galilee Christian Church, Proposed Fellowship Building Site Plan #34-09 Dear Ms. Perkins: We have revised the site plan per the comments dated December 8, 2009 and offer the following responses: Comment: Since the property owner will not sign the POA, a signature block will need to be provided for them on the coversheet. Response A signature block has been added to the cover sheet under the Sheet Index section. The applicant's signatures will be provided on the final signature sets. 2. Comment On sheet 3 the dumpster notation "the county is not responsible for maintenance or repairs" needs to be removed. A dumpster screening detail also needs to be provided. Response: The note has been removed and the screening detail is on sheet 9. 3. Comment: On the lighting plan, the foot candles need to be shown on the plan for all the fixtures (light coverage). The wall pack lighting proposed does not conform to the lighting ordinance, a full cutoff fixture needs to be shown. The mounting height for the wall pack lighting needs to be provided as well. Response: Additional foot candle levels have been added to the plan. The wall pack lighting has been revised to a full cutoff fixture and the mounting height has been added to the light label. Attached is one (1) copy of the plan for your review. Sincerely. PINE HILLS ENGINEERING, PC Scott Stickley, P.E. Civil Engineering Land Planning Onsite Sewage Disposal PINE HILLS DEC 1 `1`J ENGINE,1fi NG, PC. November 30, 2009 Frederick County Department of Planning and Development Attn: Ms. Candice E. Perkins, AICP 107 North Kent Street, Suite 202 Winchester, VA 22601 RE: Galilee Christian Church, Proposed Fellowship Building Site Plan #34-09 Dear Ms. Perkins: P.O. Box 1168 Front Royal, VA 22630 Mobile: (540) 622-3405 Fax: (540) 636-1709 We have revised the site plan per the comments dated October 5, 2009 and offer the following responses: 1. Comment: Please have the property owner sign the attached Special Limited Power of Attorney Form prior to future review or approval. This form should be notarized and completed to grant the applicant (you) with authorization to represent them for this site plan. Response: I spoke with church officials regarding this item. It was decided not to grant a Special Limited Power of Attorney to Pine Hills Engineering since the church is the applicant with the first submission. Please send all correspondence to Ms. Hazel Himelright with the church. 2. Comment: The fellowship building is an accessory use to the existing Galilee Christian Church, and parcel 44E will need to be consolidated with parcel 43 before the site plan can be approved. Response: Based on our understanding, this item has been resolved between the church and the county attorney and no other action is required. 3. Comment: The actual building height needs to be shown on the coversheet. Response: The building height has been provided on the cover sheet. 4. Comment: The parking for the fellowship building needs to be based on its use, not the number of seats (is this only an assembly hall or indoor recreation, office, etc). also, a parking calculation for the basement should be included if it is ever planned to be utilized for something other than storage. Response: The proposed use is an assembly hall with a 100 seat capacity. There are no other uses proposed and the basement is to be used for storage. At this time, I am not aware of any future uses for the basement. Civil Engineering Land Planning Onsite Sewage Disposal Galilee Christian Churvroposed Fellowship Building Page 2 5. Comment: Striped islands need to be provided as indicated on sheet 3; it appears that the parking lot could be expanded to the west to accommodate (parking setbacks -- ten feet from roads/five feet from property lines). Wheelstops also need to be shown for all parking spaces. The existing parking lot should be striped along with the new parking lot for the fellowship building. Response: Striped islands have been added and the parking lot expanded to the west as recommended. Wheestops have been graphically depicted as requested and the detail has been moved to sheet 9. The existing church building is not part of the application but I will recommend to the church to stripe the parking area on their other property. 6. Comment: Indicate on the site plan if a ROW dedication is needed. Response: To my knowledge there is no right-of-way dedication needed, VDOT did not require one as part of their approval. 7. Comment: A photometric plan needs to be included with the site plan submission; copies of the new outdoor lighting requirements are available if needed. Response: A lighting plan has been provided with illumination contours, see sheet 8. 8. Comment: A landscaping plan needs to be provided with the site plan submission that shows the required perimeter landscaping; copies of the revised parking lot requirements are available if needed. The plan needs to show the perimeter calculations (one tree per 2,000 sf of impervious area) and the number of evergreen shrubs. The landscape schedule needs to show the type of trees and shrubs being planted along with the size (2" caliper trees and 36 inch evergreen shrubs). Response: The landscaping had been updated as required with the appropriate calculations and schedule, see sheet 7. 9. Comment: On sheet 7, notes need to be provided that state (1) all planting shall conform with 165-203.01 B of the Frederick County Zoning Ordinance (Plant selection, planting procedure, and maintenance), and (2) any plant substitutions must be approved in writing by the Frederick County Planning Department. Response: The above notes have been added to sheet 7 as required. Attached is one (1) copy of the plan for your review. Sincerely, PINE HILLS ENGINEERING, PC Scott Stickley, P.E. N I��. ofg+Td�I)EIZICK Department of Planning and Development 540/665-5651 FAX: 540/665-6395 October 5, 2009 Mr. Scott Stickley, PE Pine Hills Engineering, PC P.O. Box 1168 Front Royal, Virginia 22630 Re: Review Comments for Site Plan #34-09; Galilee Christian Church Fellowship Building Property Identification Number (PIN): 32-A-44E Dear Scott: 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. Please 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 giant the applicant (you) with authorization to represent them for this site plan. 2. Lot Consolidation. The fellowship building is an accessory use to the existing Galilee Christian Church, and parcel 44E will need to be consolidated with parcel 43 before the site ppa plan can be approved. 3. plan Building aHeight. The actual building height needs to be shown on the coversheet. 4. Parking Calculation. The parking for the fellowship building needs to be based on its use, not the number of seats (is this only an assembly hall or indoor recreation, office, etc). Also, a parking calculation for the basement should be included if it is ever planned to be utilized for something other than storage. 5. Parking Lot. Striped islands need to be provided as indicated on sheet 3; it appears that the parking lot could be expanded to the west to accommodate (parking setbacks — ten feet from roads/five feet from property lines). Wheelstops also need to be shown for all parking spaces. The existing parking lot should be striped along with the new parking lot for the fellowship building. 6. Russell Road. Indicate on the site plan if a ROW dedication is needed. 7. Site Lighting. A photometric plan needs to be included with the site plan submission; copies of the new outdoor lighting requirements are available if needed. 107 North Kent Street, Suite 202 m Winchester, Virginia 22601-5000 �J r� Mr. Scott Stickle), RE: Site Plan 434-09 October 5, 2009 Page 2 8. Landscaping. A landscaping plan needs to be provided with the site plan submission that shows the required perimeter landscaping; copies of the revised parking lot requirements are available if needed. The plan needs to show the perimeter calculations (one tree per 2,000sf of impervious area) and the number of evergreen shrubs. The landscape schedule needs to show the type of trees and shrubs being planted along with size (2" caliper trees and 36 inch evergreen shrubs). 9. Landscaping Notes. On sheet 7, notes need to be provided that state (1) all planting shall conform with § 165-203.01 B of the Frederick County Zoning Ordinance (Plant selection, planting procedure, and maintenance), and (2) any plant substitutions must be approved in writing by the Frederick County Planning Department. 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 arc required From the following agencies: the Frederick County Inspections Department, the Freclerick County Department of Public Hl'orks (County Engineer), the Frederick County Fire Marshal, the health Department, the Frederick County G.I.S. Deprn•tment and the Virginia Department offransl)ortalion. Do not hesitate to contact me if you have any questions or concerns regarding this letter. Sincerely, Candice E. Perkins, AICP Senior Planner Attaclunent CEP/bad cc: Trustees of Galilee Clu-istian Church, 1831 Welltown Road, Clearbrook, VA 22624 0 • SITE PLAN APPLICATION Department of Planning and Development Use only. Date application received: VKIC)q Application #__ Fees received: Initials: 1. Project Title: Galilee Christian Church Fellowship Building 2. Location of Property Adjacent to Existing Galilee Christian Church (street address) 1831 Welltown Road Clear Brook, VA 22624 3. Property Owner: Trustees of Galilee Christian Church Address: 1831 Welltown Road Clear Brook, VA 22624 Telephone: 4. Applicant/Agent Trustees of Galilee Christian Church Address 1831 Welltown Road Clear Brook, VA 22624 Telephone: 5. Designer: Pine Hills Engineering, PC Address: P.O. Box 1168 Front Royal, VA 22630 Telephone: (540) 622-3405 Contact: Scott Stickley, P.E. ,qrp 1 8 0u", 6 • • 6a. Is this a standard or 'minor' site plan? Standard X Minor 6b. Is this an original or revised site plan? Original X Revised 7a. 7b. 8. a) b) c) d) e) D g) Total acreage of parcel to be developed Total acreage of parcel: Property Information: Property Identification Number: Current Zoning: Present Use: Proposed Use: Adjoining Property Use(s) Adjoining Property Identification Number(s) Magisterial District(s) 1.60 ACRES 5.32 ACRES 32-A-44E RA Vacant Church Fellowship Hall Residential 32-22-3, 32-22-4 Gainsboro 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. 0� Signature: d � > _ � _ �• /J , � u.,•�� Date: 9 I 1 ,3 / v 9 7 n LJ n LJ Request For Site Plan Comments Department of Planning and Development Mail to: Department of Planning and Development Attn: County Planner 107 North Kent Street Winchester, VA 22601 (540) 665-5651 Hand deliver to: 107 N. Kent Street North Building, 2"d Floor Winchester, VA (540) 665-5651 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: Address: C�� C W ,t,, kP0 60,.} Phone Number: Name of development and/or description of the request: gp?cyjz�: buu--DIi LI Location of property: - :u- owti Planning and Development's Comments: Planning and Development use only Date received Incomplete Date reviewed Signature and Date _ Signature and Date (revision Date revision received Incomplete Date reviewed 15 Date approved S E P 1 8 2009 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 NOT MEET YOUR APPROVAL PLEASE PROVIDE COMMENTS AS TO WHAT YO U WO ULD LIKE TO HA VE COMPLETED. INITIALS DATE & TIME ' Candice Mark' Dana Eric Mike John COMMENTS: Received by Clerical Staff (Date & Time): - 55D qj '171 o l U:\Pam\Common\Document Approval Form.wpd