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01-24 ApplicationTo be completed by Planning Staff: Zoning Amendment Number 01-24 Date Received 01/31/24 Fee Amount Paid $10,760.00 Anticipated PC Hearing Date Anticipated BOS Hearing Date REZONING APPLICATION FREDERICK COUNTY, VA DEPARTMENT OF PLANNING & DEVELOPMENT 1.Property Owner(s) (please attach additional page(s) if more than two owners): Name: Specific Contact Person if Other than Above: Address: Telephone: Email: Name: Specific Contact Person if Other than Above: Address: Telephone: Email: 2.Other Applicant Party (such as a contract purchaser) (please attach additional page(s) if necessary): Name: Specific Contact Person if Other than Above: Address: Telephone: Email: 3.Law firm, engineering firm, or other person, if any, serving as the primary contact person for this application: Firm Name: Specific Contact Person at Firm: Address: Telephone: Email: Please note that, if a law firm, engineering firm, or other person, other than the owner of the property, will be acting on behalf of the owner and/or executing papers on behalf of the owner in connection with the rezoning, the owner will need to execute a power of attorney form granting the firm or person such authority. 12 03/06/202403/27/24 4.Project Name (if any): 5.Property Information: a.Property Identification Number(s): b.Total acreage of the parcel(s): c.Total acreage of parcel(s) to be rezoned (if other than whole parcel(s) is being rezoned): d.Current zoning designation(s) and acreage(s) in each designation: e.Proposed zoning designation(s) and acreage(s) in each designation: f.Magisterial District(s): g.Location - the property is located at (give street address(es) if assigned or otherwise exact location based on nearest road and distance from nearest intersection, using road names and route numbers): h.Adjoining Properties: Parcel ID Number Use Zoning Please attach additional page(s) if necessary. Property identification numbers, magisterial districts, and deed book and page numbers/ instrument numbers may be obtained from the Office of the Commissioner of the Revenue, Real Estate Division, 107 North Kent Street, Winchester, VA 22601. 13 6.Disclosure of real parties in interest. Virginia Code § 15.2-2289 provides that localities may by ordinance require any applicant for a zoning amendment to make complete disclosure of the equitable ownership of the real estate to be affected including, in the case of corporate ownership, the name of stockholders, officers, and directors, and in any case the names and addresses of all real parties of interest. Frederick County has, by County Code § 165-101.09, adopted such an ordinance. For each business entity that is an owner or contract purchaser of the property, please list the name and address of each person owning an interest in, or who is an officer or director of, any entity that is an owner or contract purchaser of the property (you need not indicate the amount or extent of the ownership interest). Please note that this requirement does not apply to a corporation whose stock is traded on a national or local stock exchange and having more than 500 shareholders. Please attach additional page(s) if necessary. 7.Checklist. Please check that the following items have been included with this application: □Location Map □Plat Depicting Metes/Bounds of Proposed Zoning □Impact Analysis Statement □Proffer Statement (if any) □Agency Comments □Fee □Copies of Deed(s) to Property(ies) □Tax Payment Verification □Digital copies (pdf’s) of all submitted items 14 16 Owners of property adjoining the land will be notified of the Planning Commission and the Board of Supervisors meetings. For the purpose of this application, adjoining property is any property abutting the requested property on the side or rear or any property directly across a public right-of-way, a private right-of-way, or a watercourse from the requested property. The applicant is required to obtain the following information on each adjoining property including the parcel identification number which may be obtained from the office of the Commissioner of Revenue. The Commissioner of the Revenue is located on the 2nd floor of the Frederick County Administrative Building, 107 North Kent Street. Name and Property Identification Number Address Name Property # Name Property # Name Property # Name Property # Name Property # Name Property # Name Property # Name Property # Name Property # ADJOINING PROPERTY OWNERS