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HomeMy WebLinkAbout39-16 The Village at Orchard Ridge Parking Addition - PIN 52-A-50 - Gainesboro - BackfilePlease note: The site plans associated with this tale -are located in the file room. NOTES RECEIPT DATE 111,4 1� NO. 541135 RECEIVED FROM nn� VI ( ul C9vC�x�rZ^a ADDRESS q(y)IJ�+(-)w ►� QiC'1CIC iJr . 1 Y S ►` VA Th rEc a-hou,s and .SEvcn h LLnd,r.�J -'go' $ 3-700 .00 FOR c� I —TV—D iZ—PcLV- Liog ACCOUNT HOW PAID AMT. OF ACCOUNT CASH AMT. PAID 3.� �/� QO CHECK -7 j ------ BY BALANCE DUE MONEY ORDER ©2001 rEgFartM ® 81-818 Comment Sheets: GIS Sanitation Authority Inspections Public Works Parks & Rec Health Dept. OPEN FILE: CLOSE FILE: tDL-S --/ SrTE PLAN TRACKING SHEET VDOT Winchester Stephens City Middletown Airport Fire One copy of Site Plan application form Payment of site plan review fee One reproducible copy of Site Plan File Opened Reference Manual updated/number assigned D-base updated Application Action Summary updated Approved (or denied) letter mailed to applicant/copy to file and cc's File stamped "approved", " denied" or "withdrawn" Reference Manual updated D-base updated .�Ljb Application Action Summary updated r Sys ID # Updated 3113114 0 COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 December 5, 2016 Dennie Dunlap Dice Engineering, PLC 101 Shelby Court Winchester, VA 22602 Re: Approval Letter for Minor Site Plan #39-16, The Village at Orchard Ridge (TVOR) — Parking Addition Property Identification Number (PIN): 52-A-50 Dear Mr. Dunlap: The above -referenced minor site plan was approved on December 5, 2016. The minor site plan is approved for additional twenty-four (24) employee and visitor parking spaces and relocation of interior landscaping at the Orchard Woods Health Center within The Village at Orchard Ridge in the Gainesboro magisterial district. All requirements of the Frederick County Zoning Ordinance have been met in the approved minor site plan, including review agency comments from all relevant review agencies. I am providing you with three (3) 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, M. Tyler Klein, AICP Planner MTK/pd Attachments cc: Charles S. DeHaven Jr., Chairman of the Board of Supervisors Kevin W. Kenney and Charles E. Triplett, Gainesboro Planning Commissioners Jane Anderson, Real Estate Commissioner of Revenue The Village at Orchard Ridge, 400 Clocktower Ridge Drive, Winchester, VA 22603 107 North Kent Street, Suite 202 a Winchester, Virginia 22601-5000 • 0 TRANSMITTAL COVER 0 DICE ENGINEERING, PLC TO: Dept. of Planning & Development 107 N. Kent St. Winchester, VA 22601 101 Shelby Ct. ATTN: Tyler Klein Winchester, VA 22602 (540) 974-5157 (phone) DATE: 12/5/2016 (540) 723-4968 (fax) RE: NOR Parking Additions Site Plan office@dice-eng.con-i PROJECT NO,: 16-20 WE ARE SENDING YOU THE FOLLOWING ITEMS: COPIES DATED NUMBER ITEM DESCRIPTION 5 11/4/2016 C-01 to C-12 Proposed TVOR Phase II Parking Additions Site Plan (rev. 11-18-16) 1 12/2/2016 Inspections Dept. approval 1 CD containing PDF file of site plan THESE ARE TRANSMITTED: �X For Approval ❑ For Your Use As Requested F� For Review and Comment ❑ Other REMARKS Please find attached the site plan for the proposed TVOR Parking Additions project for approval. Please don't hesitate to contact me if you have anv questions. Sincerely, Dennie COPY TO: SIGNED: 20 E� U Z Dennie D. Dunlap III REQUEST FOR SITE PLAN COMMENTS Frederick County Inspections Department Comment Mail to: Frederick County Inspections Department Attn: Building Official 107 North Kent Street, Winchester, Virginia 22601 it Applicant: It is your responsibility to complete this form as accurately as possible in order to assist the agency with their /(�j review Please attach two Q copies of the 3zte RIM with this sheet. Applicant's Name: Dice Engineering, PLC Mailing Address: 101 Shelby Ct Hand deliver to: Frederick County Inspections Dept. 107 North Kent Street, 2nd Floor Winchester, Virginia 22601 Phone: (540) 665-5650 Telephone: 540.974.5157 Winchester, VA 22602 Name of development and/or description of the request: The Village at Orchard Ridge Parking Additions Location of Property: 400 Clocktower Ridge Drive, Winchester, VA 22603 Inspections Department Comments: (.. Omw' a'/ t a w_ OY) 4& b� ' o�l Y�7 (S t>Ld /`/✓L Is • • Parking expans shall comply with the 2012 Virginia Uniform Statewide Building Code and ]CC/ANSI A 117.1-09 Usably nd Accessible Buildings and Facilities. 2 % of the total rking spaces provided shall meet ANSI A117.1-09 for Accessibility per Section 1106.1 • 0 ■ DICE ENGINEERING, PLC 'dJ November 18, 2016 Mr. Tyler Klein, AICP Dept. of Planning and Development 107 N. Kent St., Suite 202 Winchester, VA 22601 RE: TVOR Phase II Parking Additions Site Plan (#39-16) Planning Review Comments Dear Mr. Klein: The following represents Dice Engineering, PLC responses to your comments provided via letter, dated November 14, 2016, concerning the TVOR Phase II Parking Additions site plan review. Review comments are shown in bold italics. I am responding on a point -by -point basis to correlate with your comments. 1. Title. Please include "Phase H" in the project title. Phase 11 is now included in the project title on the cover sheet and also in the right-hand border of each sheet (see sheets C-01 to C-12). 2. Site Plan Reference. Add the site plan reference number, SP #39-16, to all sheets in the plan set. The County site plan reference number is provided on all sheets at the bottom right-hand corner of each sheet (see sheets C-01 to C-12). 3. Disturbed Area. On sheet C-01 under Project Notes, please provide the total new land area disturbed as a result of the parking lot additions. The total land disturbance of 0.45 acres is provided (see Project Note #7, sheet C-01). 4. Parking Calculations. Please provide a more specific breakdown of the parking including total parking spaces required for Phase 11, total number of parking spaces currently provided for Phase 11(based on the previously approved site plans), and total additional parking spaces proposed (i.e. 36 parking spaces). See marked -up site plan for additional details. The parking requirements are broken down more specifically for Phase II (see sheet C-01). One item worth noting is that I noticed on the original Phase I plans the parking calculations were based on 72 employees, while the most recent numbers I was provided from TVOR indicates there are 90 employees associated with Phase I. There are also some guest spaces used at the facility, and some of the cottage residents drive to the main facility for dinner, etc., hence the need for additional parking. Let me know if you need any further clarification regarding this. S. Outdoor Liahtina. Please specify in the notes on sheet C-07, Photometric Plan, that all outdoor lighting will be full cutoff and conform to the outdoor lighting 101 Shelby Ct. 540.974.5157 (phone) Email: office@dice-eng.com Winchester, VA 22602 540.723.4868 (fax) • • Dept. of Planning and Development RE: NOR Phase II Parking Additions November 18, 2016 Page 2 standards outlined in the Frederick County Zoning Ordinance, Section 165-201.07. A note pertaining to full cutoff and reference to the County Ordinance is provided (see Note #3, sheet C-07). 6. Agency Approvals. Comment sheets (approvals) are required from the following agencies: the Frederick County Inspections Department, the Frederick County Fire Marshal, and Frederick County Engineer. Comment noted, I've attached the approval letter from the County Engineer. I am waiting to receive comments from the Inspections Dept., and will forward their approval once received. Per correspondence on this date, approval from the County Fire Marshal will not be required. Please find attached one set of revised drawings for your review. Additional copies will be provided for final approval once you've had an opportunity to review and all other approvals are received. If you have any questions, please don't hesitate to contact me. Thank you for your time and consideration regarding this matter. Sincerely, Dice Engineering, PLC D D DI =- Dennie D. Dunlap III, P.E. Principal 0 0 REQUEST FOR SITE PLAN COMMENTS Frederick County Public Works Comment Mail to: Hand deliver to: Frederick County Public Works Department Public Works Department Attu: County Engineer 107 North Kent Street, 2"d Floor 107 North Kent Street, Winchester, Virginia 22601 Winchester. Virginia 22601 Phonc: (540) 665-5643 Applicant: It is ,your responsibility to complete this forrn as necuratcly as possible in order to assist. the agency with their i review. I. ' cir v trfttrsr Site ('tart wilfi this_th•ct_w Applicant's Nanic: Dice Cnginsering, PLC 1 C14plIVLII: 540.974.51.57 Mailing Address: 1n1 Shelby ct_ Winchester, VA 22602 Name of development and/or description of the request: The Village at Orchard Ridge Parking Additions Location of Property: 400 Clocktower Ridge Drive, Winchester, VA 22603 Public Works Department Comments: VM Cam. aj -FREDERICK COUNTY PUBLIC N ORKS DEPARTMENT USE ONLY - Date Received Re,;ew Number 1 ? 3 1 � (,circle one) Date Reviewed Revision Requited Hate Approvctt Signature & Date: _ 60 ** Please Return Form to A—ppiicant" 19 COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 November 14, 2016 Dennie Dunlap III, PE Dice Engineering, PLC 101 Shelby Court Winchester, VA 22602 Re: Review Comments for Site Plan #39-16; The Village at Orchard Ridge (TVOR) — Parking Addition Property Identification Number (PIN): 52-A-50 Dear Mr. Dunlap: 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. Site plan approval will not be granted until the issues in this letter, as well as all issues of the other review agencies, have been adequately addressed. Please review Staffs comments listed below and then prepare a revised site plan which adequately addresses each concern. Review Comments: 1) Title. Please include "Phase 2" in the project title. 2) Site Plan Reference. Add the site plan reference number, SP# 39-16, to all sheets in the plan set. 3) Disturbed Area. On Sheet C-01 under Project Notes, please provide the total new land area disturbed as a result of the parking lot additions. 4) Parking Calculations. Please provide a more specific breakdown of the parking including total parking spaces required for Phase 2, total number of parking spaces currently provided for Phase 2 (based on the previously approved site plans) and total additional parking spaces proposed (i.e. 36 parking spaces). See marked -up site plan for additional details. 5) Outdoor Lighting. Please specify in the notes on Sheet C-07, Photometric Plan, that all outdoor lighting will be full cutoff and conform to the outdoor lighting standards outlined in the Frederick County Zoning Ordinance, Section 165-201.07. 6) Agency Approvals. Comment sheets (approvals) are required from the following agencies: the Frederick County Inspections Department, the Frederick County Fire Marshal, and the Frederick County Engineer. 107 North Kent Street, Suite 202 9 Winchester, Virginia 22601-5000 1, Re: SP #39-16; The Village at Orchard Ridge — Parking Addition November 14, 2016 Page 2 of 2 After you have revised the site plan, please resubmit one (1) copy so that Staff may verify the information contained on the plan addresses the above comments. Staff will also need all approved review agency comment sheets, at least five (5) copies of the final plan, and a digital (PDF) copy for approval. Do not hesitate to contact me if you have any questions or concerns regarding this letter. Thank you for your consideration. Sincerely, M. Tyler Klein, AICP Planner MTK/pd Attachment cc: The Village at Orchard Ridge, 400 Clocktower Ridge Drive, Winchester, VA 22603 J 1 2. SITE PLAN APPLICATION • � Ojfice Use Only-. z n Date -Application Received: (. 1:- P s `.1; `s Application Fees Received: 0o• Receipt #: 5 "1 1155 Initials: 5 Project Title: The Village at Orchard Ridge Parking Additions Location of Property (Street address) 400 Clocktower Ridge Drive Winchester, VA 22603 3. Applicant/Designer: Name: Dice Engineering, PLC Telephone: 540.974.5157 Address: 101 Shelby Ct. Winchester, VA 22602 4. Property Owner (if different than above): Name: The Village at Orchard Ridge, Inc. Telephone: 540.431.2800 Address: 400 Clocktower Ridge Drive Winchester, VA 22603 5. Property Information: a. Property Identification Number: 52-A-50 b. Total acreage of the parcel to be developed: 131.06 c. Total disturbed area of the parcel: 0.45 d. Present Use: Continuing Care Retirement Community e. Proposed Use: Continuing Care Retirement Community f. Magisterial District(s) Gainesboro 8 • 6. Site Plan Type: a. Is this an original or new site plan? b. Is this a revised site plan? If yes provide all previous site plan numbers: c. Is this a minor site plan? If yes provide all previous site plan numbers: 7. Zoning Information: Yes IV 1_ Yes 0 No No Yes L] No 1-1 04-11, 29-12, 09-14 a. Current Zoning: Ms b. Was this property Rezoned? Yes No C. If yes provide the rezoning number for this property: 01-09 d. Are there any proffers for this property? Y e. Has a MDP been approved for this property? Y f. If yes provide the MDP number for this property: 8. Adjoining property zoning and use: North East South West USE Wastewater Treatment, Orchard, Woodland Woodland, Orchard RA RA Undeveloped B2 Undeveloped, Pasture B2, RA es es No No F-1 ZONING 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: Date: November 4, 2016 9 0 • SITE PLAN APPLICATION CHECKLIST The checklist shown below specifies the information which is required to be submitted as part of the site plan application. The Department of Planning & Development will review 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). F(1) One (1) s et of a pproved c omment s heets a re r equired f rom e ach r elevant review agency prior to final approval of a site plan. It is recommended that applicants c ontact t he D epartment of P lanning & D evelopment t o de termine which review a gencies ar e r elevant to their s ite pl an application. A lis t of potentially relevant review agencies is shown below: r l Frederick County Department of Planning & Development ❑ Virginia Department of Transportation (VDOT) ❑ Department of GIS (Geographic Information Services) ❑ Frederick County Sanitation Authority Frederick County Building Inspections Department Frederick County Department of Public Works ❑ Frederick County Fire Marshal Virginia Department of Health ❑ Frederick County Department of Parks & Recreation ❑ City of Winchester ❑ Town of Stephens City ❑ Town of Middletown ❑ Winchester Regional Airport Authority ❑ Frederick County Public Schools (for residential plans) ✓V (2) One (1) copy of the Site Plan application form. 7_ (3) Payment of the site plan review fee. �✓ _ (4) Two (2) copies of the site plan for review. (5) Completed Special Limited Power of Attorney (original). ❑ (6) Traffic Impact Analysis (if applicable). 10 • 0 SITE PLAN CHECKLIST The Site Plan Checklist, shown below, lists the information which is required to be on each site plan. Site plans which are incomplete or missing information will be returned to the applicant (s) for revision. Project Information Section (1) A title that includes the name of the proposed or existing business and a subtitle which describes the proposed development. (2) The name, address, and phone number of the land owner, developer, and designer. (3) The Frederick County Property Identification Number (PIN) of all lots included on the site plan. (4) The number and type of dwelling units included on the site plan for residential uses. (5) The total land area and total developed land area of all lots included on the site plan. (6) A de tailed de scription o f the proposed use or uses o f the development, a s well a s a description of the existing use or uses. (7) A reference to any other site plan, master development plan approved by the county for the site. (8) The date the site plan was prepared and a list of all revisions made, including the date and a description of why the site plan was revised. ✓� (9) A table of contents including all pages of the site plan. (10) A list of all proposed utility providers, with their address, name and phone number. (11) A I ocation in ap showing t he 1 ocation o f t he s ite, along w ith t he location o f s treets, roads and land uses within five hundred (500) feet of the property. (12) A statement listing all requirements and conditions placed on the land included in the site plan resulting from approval of conditional zoning or a conditional use permit. (13) A description of setbacks or conditions placed on the site as a r esult of an approved variance. (14) The name of the Magisterial District the property is located within. Calculations Section (15) Calculations showing the Floor Area Ration (FAR) of the site, including the maximum allowed FAR, total ground floor area, total floor area, and total lot area. (16) Calculations s bowing t he total num ber of required and pr oposed p arking s paces, 11 including the total number of existing and proposed spaces. (17) Calculations showing the total number of required handicap spaces, including the total number of existing and proposed spaces. (18) Calculations showing the total number of required loading spaces, including the total number of existing and proposed spaces. (19) Calculations s howing t he t otal num ber of required pe rimeter a nd i nterior trees required, including the number of provided trees. (20) Calculations showing the percentage of the property that will be landscaped and the percentage of woodlands disturbed. (19) Calculations s howing t he t otal num ber of required pe rimeter a nd i nterior trees required, including the number of provided trees. Site Plan & Details Section a(21) The 1 ocation of a 11 a djoining 1 ots w ith the ow ner's name, s pecific u se, z oning, and zoning boundaries shown. (22) The location of all existing or planned right-of-ways and easements that are located on or adjoin the property, with street names, widths, and speed limits shown. (23) All ne arby a ntrances t hat a re w ithin t wo hund red ( 200) f eet of a ny a xisting or proposed entrances to the site. 7 (24) All existing and proposed driveways, parking and loading spaces, parking lots and a description of s urfacing m aterial a nd c onstruction de tails t o be us ed. T he s ize a nd angle of parking spaces, aisles, maneuvering areas, and loading spaces shall be shown. (25) A North arrow. (26) A graphic scale and statement of scale. �✓ (27) A legend describing all symbols and other features that need description. (28) A boundary survey of the entire parcel and all lots included with distances described at least to the nearest hundredth of a foot. (29) The present zoning of all portions of the site, with the location of zoning boundaries. (30) The 1 ocation o f a 11 a xisting a nd pr oposed s tructures, w ith t he height, s pecific use, ground floor area, and total floor area labeled. (31) The location of all existing and proposed outdoor uses, with the height, specific use, and land area labeled. (32) Existing topographic contour lines at intervals acceptable to the Zoning Administrator. Proposed finished grades shall be shown by contour. 12 0 9 (33) The location of the front, side, and rear yard setback lines required by the applicable zoning district. (34) The location and boundaries of existing environmental features, including streams, floodplains, lakes and ponds, wetlands, natural stormwater retention areas, steep slopes, and woodlands. U/A (35) The location of outdoor trash receptacles. (36) A Photometric Plan per § 165-201.07. F—IN 1A (37) The location, dimensions, and height of all signs. (38) The location of required buf fers, landscaping buf fers, a nd 1 andscaped s creens, including examples, typical cross sections or d iagrams of screening to be used. The location and d imensions o f required f encing, be rms, and s imilar features s hall be specified. N /A (39) The location of recreational areas and common open space. _Z (40) The location of all proposed landscaping with a legend. The caliper, scientific name, and common name of all deciduous trees. The height at planting, scientific name, and common name of all evergreen trees and shrubs. (41) The height at planting, caliper, scientific name, and common name shall be provided for all proposed trees. The height at planting, scientific name and common name shall be provided for all shrubs. (42) The location of sidewalks and walkways, including all sidewalks or bi cycle paths required along any road right of way. N /A (43) The location and width of proposed easements and dedications. (44) A stormwater management plan describing the location of all stormwater management facilities with design calculations and details. FVI (45) A soil erosion and sedimentation plan describing methods to be used. N /A (46) The location and size of sewer and water mains and laterals serving the site. 13 • 1— (47) Facilities necessary to meet the requirements of the Fire Code. (48) A si gned seal o f the c ertified Virginia 1 and surveyor, architect, or engineer who prepared the plan. The seal and signature of the engineer, surveyor or architect shall be on each sheet of the site plan. (49) A s pace 1 abeled "Approved by t he F rederick C ounty Z oning A dministrator" for t he signature of the Zoning Administrator, approval date, and a statement that reads "site plan valid for five (5) years from approval date." ✓�_ (50) All requirements specified elsewhere in the County Code, including but not limited to the Subdivision Ordinance. 14 Special Limited Power of Attorney County of Frederick, Virginia Frederick Planning Website: www.co.frederick.va.us Department of Planning & Development, 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) (Nape) The Village at Orchard Ridge, Inc. (Address) 400 Clocktower Ridge Drive, Winchester, VA 22603 (Phone) 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. TM52-A-50 on Page Parcel: Lot: Block: Section: do hereby make, constitute and appoint: (Narie) Dice Engineering, PLC and is described as Subdivision: (Phone) 540.974.5157 (Address) 101 Shelby Ct., Winchester, VA 22602 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) _M -Conditional Use Permit _Master Development Plan (Preliminary and Final) Subdivision Site Plan _Variance or Appeal 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 In witness thereof, I ( e) have hereto set my (our) h d and seal this 3 day of V/wem i Signature(s) U M State of Virginia, City/County of )5�ederi �K , To -wit: I, 610 ftV -..y,V JA/,+rV(Z S a Notary Public in and for the jurisdiction certify that the person(s) who signed to the foregoing instrument personally p �d before m acknowl ed the same before mein the jurisdiction aforesaid this 3 day of 20 /4 . 1� 1�. wk aforesaid, and has My Commission Expires: k;L- _, .30, (W.20 Notary Pu • REQUEST FOR SITE PLAN COMMENTS Frederick County Department of Planning & Development Mail to: Frederick County Department of Planning & Development 107 North Kent Street, Winchester, Virginia 22601 Phone: (540) 665-5651 • Hand deliver to: Frederick County Department of Planning & Development 107 North Kent Street, 2nd Floor Winchester, Virginia 22601 Applicant: it is your responsibility to complete this form 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. Applicants Name: Dice Engineering, PLC Telephone: 540.974.5157 Mailing Address: 101 Shelby Ct. Winchester, VA 22602 Name of development and/or description of the request: The Village at Orchard Ridge Parking Additions Location of Property: 400 Clocktower Ridge Drive, Winchester, VA 22603 Department of Planning & Development Comments: -PLANNING DEPARTMENT USE ONLY - Date Received Review Number 1 2 3 4 5 (circle one) Date Reviewed Revision Required Date Approved Signature & Date: 1 ** Please Return Form to Applicant** 16 • 0 TRANSMITTAL COVER llvv � ?� 3;i'>✓ £ �E N G•l N E E R I N G , PLC TO: Dept. of Planning & Development -0 107 N. Kent St. Winchester, VA 22601 101 Shelby Ct. ATTN: Tyler Klein Winchester, VA 22602 (540) 974-5157 (phone) DATE: 11/4/2016 (540) 723-4868 (fax) RE: NOR Parking Additions Site Plan office@dice-ens.com PROJECT NO.: 16-20 WE ARE SENDING YOU THE FOLLOWING ITEMS: COPIES DATED NUMBER ITEM DESCRIPTION 2 11/4/2016 C-01 to C-12 Proposed TVOR Parking Additions Site Plan 1 11/4/2016 Site Plan Application 1 Request for Site Plan Comments 1 Review Fee Check for $3700 payable to Treasurer of Frederick Co. 1 Special Limited Power of Attorney Form THESE ARE TRANSMITTED: ❑ For Approval ❑ For Your Use ❑ As Requested ❑X For Review and Comment ❑ Other REMARKS Please find attached the site plan submission package for the proposed TVOR Parking Additions project. Please don't hesitate to contact me if you have any questions. Dennie COPY TO: SIGNED: C) f) Qj Dennie D. Dunlap III 0 0 NOV 4 2016 FFZ1 �c T r 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 PRO BIDE COMMENTS AS TO WHAT YOU WOULD LIKE TO HAVE COMPLETED. Initials Date & Time Candice Mark Dave yler Mike John COMMENTS:_�'`7 C C �� Received by Clerical Staff (Date & Time): (S:Oflice on BlackboxWormsWocument Approval Form —6/7/2016 ) y z,e opw