HomeMy WebLinkAbout28-05 Beverly Longerbeam 45' Both Sides - Stonewall - BackfileW-
BOARD OF ZONING APPEALS
Variance Request Tracking Sheet
Date:
File opened
Reference Manual updated/number assigned
f D-base updated
11-),/Ak-4)ne43&W location map requested from GIS
>07�1. "S7" —7V IkAc-
�Z Two sets of labels requested from Data Processing
File given to Renee' to update Application Action Summary
MEETING DATE: / % ", FINAL ACTION:
CLOSE OUT FILE:
C , Approval (or denial) letter mailed to applicant/copy made for file
�(4 File stamped "approved", "denied" or "withdrawn"
Reference Manual updated
l z
D-base updated
�19.0 File given to Renee' for final update to Application Action Summary
0 53
U\Bev\Common\Tracking sheets\BZA Tracking.bza
Revised 05/25/01
(9�
DATE NO. 4801
RECEIVED FROM
ADDRESS
DOLLARS
FOR
H&A/ PAID
-AMT OF
ACCOUNT A.C2.L!T 1CASH H
AMT. � HECK
13ALANCE 7MQ'EYDUE MONEY
BY
couWYNAMCK
Department of Planning and Development
540/ 665-5651
FAX: 540/ 665-6395
January 18, 2006
Mr. Beverly Longerbeam
General Contracting, Inc.
269 Christmas Tree Lane
Stephenson, VA 22656
RE: VARIANCE REQUEST 428-05, WITH MODIFICATION
Dear Mr. Longerbeam:
This letter is to confirm that the above -referenced application was approved by the Board of
Zoning Appeals at their meeting on January 17, 2006. Your request on parcel bearing Property
Identification Number 45-2-C was for a 5' variance on both sides. However, the Board of
Zoning Appeals voted to allow you a 2' variance on both sides. The property is located on
Gun Club Road (Route 666), in the Stonewall Magisterial District.
If you have any questions regarding this action, please feel free to call this office.
Sincerely,
ark R. Cheran
Zoning and Subdivision Administrator
MRC/bad
cc: Jane Anderson, Real Estate
John Trenary, Inspections
Mildred Cole, 333 Wood Ave., Winchester, VA 22601
107 North Kent Street, Suite 202 - Winchester, Virginia 22601-5000
•
COUNTY of FREDERICK
Department of Planning and Development
540/665-5651
FAX:540/665-6395
MEMORANDUM
TO: Finance Department
FROM: Pam Deeter, Office Assistant II
SUBJECT: Return Of Sign Deposit
DATE: January 20, 2006
The amount of $50.00 was deposited in line item 93-010-019110-0008. Beverly Longerbeam
named below had a deposit for one sign for a Variance #28-05. Beverly Longerbeam has
returned the sign and is therefore entitled to the return of the deposit. You may pay this through
the regular bill cycle.
Please send a check in the amount of $50.00 to:
Beverly Longerbeam
PO Box 99
Stephenson, VA 22656
107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000
0 0
Sanitary District
Street Light
Nov. I Dog tags go on sale
Dec. 5 Second Half Taxes Due
Personal Property
Real Estate
Sanitary District
Street Light
Other due dates as billed bthe Commis Revenue's Ofstoner of the
Off -ice.
M iIine Address
Frederick County Treasurer
P.O. Box 225
Winchester, VA 22604-0225
(540)665-5607
E-ma
il Address
BOrndoff@co.frederick.va.us
For Tax Information & Online Pa ments
W W W. CO. FREDERICK. V A. US
Treasurer's Office Hours
Monday through Friday 8:30 am to 5:00 pm
xtended hours may be offered during peak times, watch
for details in local media.
s s r s► s s s a a s s r s s r r a s a s a r r a r s a a r s r r s a r
)R VEHICLE LICENSE REGISTRATION
eclare that the statement and figures hereon are true, full an-'rect to the best of my knowledge and belief. T A X R E C E I P T
:ed 50% for Business
Yes _ 6ERICK COUNTY
;nature WILLIAM ORNDOFF, JR
nature P.O. BOX 225
VA 22604-0225
WINCHESTER
SIGN DEPOSITS PLANNING
Ticket #:00005230001
Date : 12/20/2005
Register: BCC/BC
Trans. #: 50844
Dept # 1095
Acct#
Previous 100.00
Balance $
100.00
Principal Being Paid $ .00
Penalty $ .00
Interest $
Amount Paid $
100.00
*Balance Due $
.00
Cash 1.80
Check 11288.32 # VARIOUS
Po' �Jy PJ,AJVNING THE MONTH 12/2005
/J Tal
RA T ANCE DUE INCLUDES . ZAfzLffl,7f z� ,/
•
•
If
ATE .?. I ` (� NO. 4801
pp p0
ECEIVED FROMDORESS
d '9
AZ
:. r 0R DOLLARS $ { 00 Op
OF ACCOUNT HOW PAID
.•'' I I�IIINI _ ACCOUNT I CASH
`r ljflllll AMT. PAID CHECK
BADUECE I MONEY `t\ jfji
ORDER � BY
i.
VARIANCE APPLICATION #28-05
BEVERLY LONGERBEAM
Staff Report for the Board of Zoning Appeals
Prepared: January 9, 2006
Staff Contact: Kevin T. Henry, Planning Technician
This report is prepared by the Frederick County Planning Staff to provide information to the Board
of Zoning Appeals to assist them in making a decision on this request. It may also be useful to
others interested in this zoning matter.
BOARD OF ZONING APPEALS HEARING DATE:
January 17, 2006 - Action Pending
LOCATION: Gun Club Road (Route 666)
MAGISTERIAL DISTRICT: Stonewall
PROPERTY ID NUMBERN: 45-2-C
PROPERTY ZONING & USE: Zoned: RA (Rural Areas)
Land Use: Vacant and Residential
ADJOINING PROPERTY ZONING & USE:
North: RA (Rural Areas)
South: RA (Rural Areas)
East: RA (Rural Areas)
West: RA (Rural Areas)
Use: Agricultural
Use: Residential
Use: Residential
Use: Residential
VARIANCE REQUESTED: 5' variance on both sides, with 45' setbacks
REASON FOR VARIANCE: Narrowness of the lot
• 0
Variance Request #28-05, Beverly Longerbeam
January 9, 2006
Page 2
STAFF COMMENTS:
Frederick County adopted zoning in 1967. The Frederick County historical zoning map shows this
1.13 acre property was zoned A-2 (Agricultural General) in 1972. The property setback lines at the
adoption of the zoning ordinance were 35' for the front, 25' to the rear and 15' for the side yards.
Frederick County amended its Ordinance in 1989 to change the rural zoning districts to the current
RA (Rural Areas) Zoning District, making the current setbacks for the property 60'front, 50'rear and
50' to the sides.
STAFF CONCLUSIONS FOR THE JANUARY 17, 2006 MEETING:
The Code of Virginia, Section 15.2-2309(2), states that no variance shall be authorized bythe Board
unless it finds that a) strict application of the Ordinance would produce an undue hardship; b) that
such hardship is not shared generally by other properties in the same zoning district and the same
vicinity; and, c) that the authorization of such variance will not be of substantial detriment to
adjacent property, and that the character of the district will not be changed by the granting of the
variance.
The applicant is seeking a variance of 5' on both sides of the property (East and West). Should this
variance be granted, the building setbacks for this property would be: 60' in the front, 50' in the
back, and would change to 45' on the sides. It appears that this variance meets the intent of the Code
of Virginia, Section 15.2-2309 (2). This request from the current setbacks of the RA zoning district
may be justified.
'0
BOYCE,ELRAV
51 6
CO3�11\51LSDAKAY
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KRUPP, RUSSELL L
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BEN HER, ROGER A SR 4 TAMMY S
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AVATION OF SRNC., INC
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STUR(�MS, JAMES C. a LDRRENE 0.
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TUCKER BLAIRL
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Map Features
Zoning
VAR # 28
- 05
^/ Bridges
8Appbcaticn
^/ Culverts
® SIMusiness, Neighborhood District) MS (Medical Support Distrito)
LekeslPonds ^v Dams
® B2 (Business, General District) ® R4 (Residentral, Planned Community District)
Beverly Lo n g
e rb e a m
ter— Streams ^/ Retaining Walls
B3 (Business, Industrial Transition District) R5 (Residential Recreational Community District)
Buildmgs Road Centerlines
EM (Extractive Manufacturing District) Q RA(Rural Areas District)
uca
HE (Higher Edtion District) Q RP (Residential Performen- District)
(45 2
C )
- Tanks N
. MI (Industrial, Light Matncl)
OParcels �400V
� M2 (industrial. General District) N
s
OSWSA �b� UDA
MH1 (Mobile Home Community District)
W E
75 150
300
Feet
S
45 A 11011
vNE�"
SNPNONO �✓� ' ' .
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COPENMAVER LINDA
N 5'1 S VkqLSON EXCAVATION -OF. WING, INC �.
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f BENNER ROGER SR&TAYMY S
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< i-!� � CLEVENGER CHARLES K
^ ♦p�� � - ♦S A 10B
PUFFINSERGER WILUAM LEE ,Z, a�
N 51 1
o �
S BRAND, MICHAELW 7-
N 6 5 IRWIRIRICHARDG
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BENTLEY, CONNOR
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STURMS, JAMES C. 6 LORRENE
IS A 10C
TUCKER B WR L MILLS,,ROY P
N 6 7 IS 3 F
APPLICATION FOR VARIANCE
IN THE
COUNTY OF FREDERICK, VIRGINIA
DEC 9 ) niz
-OFFICE LJSE ONLY-
t
Variance Application No.c `'� Subnnittal Deadline: �''� P.
Stibxnittal Date: fjFor the iiieeti ig of
Fee Paid: Cinitials:
Sign .Deposit
MUST BE TYPED OR FILLED OUT IN INK - PLEASE PRINT
1. The applicant is the owner / other . (Check one)
2. APPLICANT:
NAME:
6e*,e4l Con-W h'�1 �-itc
ADDRESS 06-1 C,r(O-a-\as Lane-,
e p �hSo►n �ff o� (o 56
TELEPHONE: (o [v S- 9 `f `7 (,,,
OCCUPANT: (if different)
NAME:.
ADDRESS:
TELEPHONE:
3. The property is located at (give exact directions and include State Route numbers):
l J 14 v'\a✓ iesTb W r1 ro a. ST-a-V I e (4 0.:t ' 1 ekkG a -
I P" (QDOrnV 3' M1I r� V) - Vh (J ob i aLX . Ld 4- d ✓l 1e4
LZD��oX . 3l q �Yi( . �Ska_rDV\ .S� *
--PT
4. The property has a road frontage of 15-0 feet and a depth of 3-�0-355 feet
and consists of :13 acres (please be exact).
Page 5 of 9
5. The property is owned by I Id-Y-4 B. CO [tf, as evidenced
by deed from recorded (previous owner) in deed book
no.: on page �5Y� of the deed books of the Clerk of the Court for
Frederick County. Please attach a copy of the recorded deed.
6. Magisterial District: �77C)y e wa,)
7. Property Identification No.: Ll 5_'02 — C
8. The existing zoning of the property is: /Z
tl-
9. The existing use of the property is: lar\OL Jjlsevahca
10. Adjoining Property:
USE
North
East
South
West
ZONING
11. Describe the variance sought in terms of distance and type. (For example: "A 3.5'
rear yard variance for an attached two -car garage.")
'Is ` vn &-/-`, Sto,
12. List specific reason(s) why the variance is being sought in terms of.
exceptional narrowness, shallowness, size or shape of property, or
exceptional topographic conditions or other extraordinary situation or condition of
property, or
the use or development of property immediately adjacent thereto
Page 6 of 9
tf C-f -
� cross
13. Additional comments, if any: 1,13 Accra Io+ w 156' S 1 °-e--
sefb eb `60 S rnal I 0r a r\ a- rep- -r r a--
h o use .
14. The following names and addresses are all of the individuals, firms, or corporations
owning property adjacent to the property for which the variance is being sought,
including properties at the sides, rear and in front of (across street from) the subject
property. (Use additional pages if necessary.) These people will be notified by mail
of this application:
N A XW
D-�AACCl
Address
Property ID # 45-
j 1' 1 � �� • Av-cp�'S c� n
O t l l wxn Le!� r�P,i-au-
U
Address &;kl.l ,,b _R0azt
Property ID #jam
Address v b o
PropertyID # —
f�J So YI r)( C'O-VO I o n
d W) m4\,-Sw #Zn C- -
Address D sv a r-�o r 4e— N n M �0
Property ID #
Address
Property ID #
Address
Property ID #
Address
Property ID #
Address
Property ID #
Page 7 of 9
15. Provide a sketch ofthe property (you may use this page or attach engineer's drawing).
Show proposed and/or existing structures on the property, including measurements
to all property lines and to the nearest structure(s) on adjoining properties. Please
include any other exhibits, drawings or photographs with this application.
Page 8 of 9
100
a
Nov 15 05 03:29p SHnRoN STINE
540 GG7812G
-pop"' rMr•�•• wwM pNr+u7 41
jamucro:qiwor in m"ir-oww "we
1161 '*1 ll*jdy
. - 17 009-1 Ze I
W.r nVOR Pain ul —laic zane..'. Al-UPO.1
2j*j.awpe4j 9411 "1 parb4ozoa pwr Z161 I 1j"If
P8.40P PMM30
Pug 1 041 is t1o12jud • el NO! 0 1 jjpqP6 11141 -
peftleluDs pug, wq4 piq; Ajf4d Aqwj*4 i
rm
O
a.
999 am& al
POWMAW
C'Z nw C4V wo
IN
• 0
AGREEMENT
VARIANCE # & - 0)
(Number to be assigned by the Planning Dept.)
I (we), the undersigned, do hereby respectfully make application, and petition the Frederick
County Board of Zoning Appeals (BZA) to grant a variance to the terms of the Frederick
County Zoning Ordinance as described herein. I agree to comply with any conditions for the
variance required by the BZA.
I authorize the members of the BZA and Frederick County officials to go upon the property
for site inspection purposes.
I understand that the sign issued to me when this application is submitted must be placed at
the front property line at least seven (7) days prior to the BZA public hearing
so as to be visible from the road or right-of-way until the hearing. and maintained
I hereby certify that all of the statements and information contained herein are, to the best
Of my knowledge, true.
SIGNATURE OF APPLICANT
DATE
SIGNATURE OF OWNER_jZ(—-C
17
DATE D % 6 6--
(if other than applicant)
-OFFICE USE ONLY-
BZA PUBLIC HEARING OF C i - 1 .7 - O (
- DATE -
APPROVAL SIG
CHAIRMAN
61—
DENIAL DATE:
Page 9 of 9
•
AGREEMENT
VARIANCE
(Number to be assigned by the Planning Dept)
I (we), the undersigned, do hereby respectfully make application, and petition the Frederick
County Board of Zoning Appeals (BZA) to grant a variance to the terms of the Frederick
County Zoning Ordinance as described herein. I agree to comply with any conditions for the
variance required by the BZA.
I authorize the members of the BZA and Frederick County officials to go upon the properly
for site inspection purposes.
I understand that the sign issued to me when this application is submitted must be placed at
the front property line at least seven (7) days prior to the BZA public hearing and maintained
so as to be visible from the road or right-of-way until the hearing.
I hereby certify that all of the statements and information contained herein are, to the best
of my knowledge, true.
SIGNA
DATE
SIGNATURE OF OWNER DATE
(if other than applicant)
-OFFICE USE ONLY-
BZA PUBLIC HEARING OF / 0ACTION:
-DATE'-
APPROVAL SIGNED:
__ � ._ 11 \I ►1
DENIAL DATE:
Page 9 of 9
Special Limited Power of Attorney
County of Frederick, Virginia
Planning Office, County of Frederick, Virginia, 107 North Kent Street, Winchester, Virginia 22601
Phone 540-665-5651
Facsimile 540-665-6395 .
Know All Men By These Presents: That I (We)
(Name)
� M-b
(Phone) lc e�if / l
(Address) —Co o D � �� /t U1 C- �X> � � (✓� � � �� �l y� ` i2 �r�� j
the owner(s) of all those tracts 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
Instrument No. -%� on Page J and is described as
Parcel: Lot: b Block: Section: Subdivision:�� �7%�t��Y1i"mil G1i2
do hereby make, constitute and appoint:
(Name) , L,C j\ 1�.�`XLQC t r_a �M (Phone) 4'7W
(Address) �� ���`� �� . ��''���i� .�lt �� Q��� D
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 applications for my (our) above described
Property, including:
❑ Rezoning (Including proffers)
❑ Conditional Use Permits
❑ Master Development Plan (Preliminary and Final)
❑ Subdivision
❑ Site Plan
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 shall expire one year from the day it is signed, or until it is otherwise rescinded or
modified.
Jn witness thereof, I (we) have hereto set my (our) hand and seal this 8� day of �er.ery 6�.r , 200.5 ,
Signature(s),_��
=State of Virginia, City/County of C".. `c. If — , To -wit:
,J e , a Notary Public in and for the jurisdiction aforesaid, certify that the person(s)
who Sied to the foregoing instrument and who is (are) known to me, personally appeared before me
and has acknowledged the same before me in the jurisdiction aforesaid this �fday of '1Dcer, "6 200-5 .
My Commission Expires: 1`-e/af--w a8 .2067
Notary Publ'
wlwc
3fveeo �� ��/ � O Gt���t TO: BARBARA- DATA PROCESSING
C' ��V FROM:BEV - Planning Dept.
- I� !� ,� Plense print sets of labels by
f~' 13. Additional comments, if any: �. 13 Ace o+ W o /o-S—
THE
se4 b ) ea-v�-
! r
ko V Se— .
14. The following names and addresses are all of the individuals, firms, or corporations
owning property adjacent to the property for which the variance is being sought,
including properties at the sides, rear and in front of (across street from) the subject
property. (Use additional pages if necessary.) These people will be notified by mail
of this application:
NAME
j of � ES Address +A A C?'W C Fj \,f
Sl y Lp--�A-V-n Property ID# b
D /1 Address u l ,6 O
Property ID #s y 3
1Leer�' e.✓ Address a d ' v r'1 Cl 1' b 120a--Ot �=
Property
Address [ t3 S� �'�'I c r' 17Ye , N 1 n r7f
r i SC )� �lC �t/�f b ✓t 7
c55 ��i ►Lc( e�S ��1-r► �• Property ID #
Address
Property ID #
Address
Property ID #
Address
Property ID #
Address
Property ID #
Page 7 of 9
REQUESTING AGENT:
DEPT. OF GEOGRAPHIC INFORMATI" SYSTEMS
FREDERICK COUNTY, VIRGP- A
GIS, N APPITG, GRAPHICS
WORKREQUEST
DATE RECEIVED:
REQUESTED COMPLETION DATE:
Department. Agency, or ComPmT--
Mailing and/or Billing Address:
Telephone:
E-mail Address:
ESTDYIATED COST OF PROTECT:
FAX:
DESCRIPTION OF REQUEST: ffri�e additional info�tion an back of resluest)- ---
DIGITAL: PAPER FAX: E-MAIL:
SIZES:
COLOR BLACKIw-HIITE: NuisER OF COPIES:
STAFF MEMBER
COMPLETION DATE:
MATERIALS -
DATE OF PICK-UP/DELIVERY:
AMOUNT DUE:
AMOUNT BILLED:
IN,[F-THOD OF PAYMENT:
HOURS REQUEZED:
AMOUNT PAID:
CHECK NO_4.
(50)665-5651)
rrederick County G15, 107 North Kent S�ze� \Jinches�er, VA 22601,
r
I COUNTY of FREDERICK
Department of Planning and Development
5401665-5651
FAX: 540/ 665-6395
NOTIFICATION OF PUBLIC HEARING
January 3, 2006
TO: THE APPLICANTS) AND/OR ADJOINING PROPERTY OWNER(S)
RE: VARIANCE REQUEST #28-05 OF BEVERLY LONGERBEAM
On behalf of the Frederick County Board of Zoning Appeals, you are hereby notified of a public
hearing being held on Tuesday, January 17, 2006, at 3:25 p.m., in the Board Room of the
Frederick County Administration Building at 107 N. Kent Street, Winchester, Virginia. This is a
public hearing to consider the following application:
Variance Request 928-05 of Beverly Longerbeam, for a 45' variance on both sides of the property.
This property is located on Gun Club Road (Route 666), and is identified with Property
Identification Number 45-2-C in the Stonewall Magisterial District.
Any interested parties may attend this hearing. A copy of the application will be available for review
at the Handley Library and the Bowman Library the week of the meeting, or at the Department of
Planning and Development located at 107 North Kent Street in Winchester, Virginia.
Sincerely,
ark R. Cheran
Zoning Administrator
MRC/bad
107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000
This is to certify th t the attached correspondence was mailed to the following on
f �lj from the Department of Planning and Development, Frederick
County, Virginia: - --
45 • A- - 9-
- - WILSON EXCAVATION OF WINC., IN
45 2- - C- 409 SUPERIOR AVE
COLE, MILDRED B� WINCHESTER, VA 22601.4253
333 WOOD AVE WINCHESTER,VA 22601-3052 h
Beverly Longerbeam
General Contracting, Inc.
269 Christmas Tree Lane t
Stephenson, VA 22656,Al �1
45 -2- - B- --
PAYTON, JAMES D & ANGELA N
942 GUN CLUB RD
STEPHENSON, VA 22656.1806
45 - 3- - D- -
ANDERSON, BRIAN K & BONNIE L
976 GUN CLUB RD
STEPHENSON, VA 22656-1806
44 -5- 1- 1-
PUFFINBERGER, WILLIAM LEE
920 GUN CLUB RD
STEPHENSON, VA 22656-1806
I
Marl-, R. Cheran, Zoning & Subdivision Administrator
Frederick County Planning Department
STATE OF VIRGINIA
COUNTY OF FREDERICK
a Notary Public in and for the State and County
aforesaid, dfi hereby certify thatA4ark R. Cheran, Zoning & Subdivision Administrator for the
Depai met of Planning and Development, whose name is signed to the foregoing, dated
p , has personally appeared before me and acknowledged the same in my
State and County aforesaid.
Given under my hand this day of Veka0?"
My commission expires on ��d
TO:BARBARA-DATA PROCESSING
FROM:BEV - Planning Dept.
�-4 #. 1 Please print sets of labels by
13. Additional comments, if any: 113 Acre w '� o 0-�— THANKS!
Se-- b ckves • r, S i�Ci I Of r� �� CAZ- re JC6 r 4;1-
kO L)Se •
A crt ss
14. The following names and addresses are all of the individuals, firms, or corporations
owning property adjacent to the property for which the variance is being sought,
including properties at the sides, rear and in front of (across street from) the subject
property. (Use additional pages if necessary.) These people will be notified by mail
of this application:
,T♦A,r,r
jOinFS ��
1 n1 O,C- �1
Address
<.
Property ID # 45-
-
►'1 �c ✓1 ��• %�v�'�'S� h
/�.7_�-�
�J
Address 4Y- 74 .C(')
Property ID #�
e*1s t A
Address a0 - v,•'I /CCa-ct�'�
Property ID #Sen — —
`�
d W) f 4,eAw -To c.•
Address e r- 4
Property ID #
Address
Property ID #
Address
Property ID #
Address
Property ID #
Address
Property ID #
9o�
Page 7 of 9
L
BEVERLY L. LONGERBEAM
I•- maxi:i:�" GENERAL CONTRACTING, INC
.liA•Ii��i�u�a lilwi z•: ••"' (540)665-9476 - ----s,er
isW IUI n Til1:„ P.O. BOX 99
STEPHENSON, VA 22656
PAY TO THE of .e_r Pc;4e
ORDER F_.___
VIKGINIA, SAVWGS
BANK
Winchester, VA 22601
FOR G� 6r�hC Qi _--
11100 29 2 Lnl is 2 S L L, 7 3 7 Si61:
04 1 _�3 4E
2921
68 7375/2514
l l
DOLLARS 8
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
COhD1INTSAS TO WHAT YOU WOULD LI%E TO HAVE COMPLETED.
INITIALS DATE & TM
Candice
Bernie
Mark
Susan
Eric
Mike
Kevin
John
CO1V 3mNTS:
Received by Clerical Staff (Date & Time):