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29-16 Valley Health at Rutherford Crossing - PIN 43-A-100F - Stonewall - Backfile
NOTES I RECEIPT DATE �!-19)1 `l NO. 541027 PAID BY ©2001 KPFPBM. ®8L818 T J(o %C UV '..__Y I BALANCE MONEY DUE ORDER SITE PLAN TRACKING SHEET Comment Sheets: GIS VDOT Sanitation Authority Winchester Inspections Stephens City Public Works Middletown Parks & Rec Airport Health Dept. Fire One copy of Site Plan application form ✓ Payment of site plan review fee ✓ One reproducible copy of Site Plan OPEN FILE: L 8-1 �- I � File Opened Reference Manual updated/number assigned D-base updated Application Action Summary updated CLOSE FILE: ny I L to Approved (or denied) letter mailed to applicant/copy to file and cc's 10106 File stamped "approved", "denied" or "withdrawn" �P Reference Manual updated 10 41 Ito D-base updated Application Action Summary updated IL -;t � dc-I Sys ID # _. Updated 3113114 COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 October 3, 2016 Michael M. Artz Pennoni Associates Inc. 117 East Piccadilly Street Winchester, VA 22601 Re: Approval for Site Plan #29-16; Valley Health Urgent Care — Rutherford Crossing Property Identification Number (PIN): 43-A-100F Dear Mr. Artz: The above -referenced site plan was approved on October 3, 2016. The site plan is approved for construction an 8,431 square foot (SF) urgent care facility at the Rutherford Crossing Shopping Center in the Stonewall Magisterial District. Required site improvements include the following: • Construction of a parking lot with 83 spaces (including six handicap accessible), including curb and gutter, striping, handicap access and landscaping; • One (1) loading space and a screened dumpster area; and • Landscaping and lighting as indicated on the site plan. 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. Attached are five (5) copies of the signed site plan by the Zoning Administrator. 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: Judith McCann -Slaughter, Stonewall Magisterial District Gary R. Oates & William H. Cline, Stonewall District Planning Commissioner Jane Anderson, Real Estate Commissioner of Revenue Rutherford Farm LLC, 8230 Leesburg Pike, Suite 620, Vienna, VA 22182 107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000 • Pam Deeter From: Judy McCann -Slaughter To: Pam Deeter Sent: Tuesday, October 04, 201611:12 AM Subject: Read: Approval of site plan Your message To: Judy McCann -Slaughter Subject: Approval of site plan Sent: Tuesday, October 04, 201611:06:17 AM (UTC-05:00) Eastern Time (US & Canada) was read on Tuesday, October 04, 201611:11:43 AM (UTC-05:00) Eastern Time (US & Canada). 9 • Pam Deeter From: Microsoft Outlook To: Judy McCann -Slaughter Sent: Tuesday, October 04, 201611:06 AM Subject: Delivered: Approval of site plan Your message has been delivered to the following recipients: Judy McCann -Slaughter (islaushter@fcva.us) <mailto:islauehter@fcva.us> Subject: Approval of site plan u • Pam Deeter From: Mail Delivery System < MAILE R- DAEMON @co.frederick.va.us > To: wcline.fredcogovpc@icloud.com Sent: Tuesday, October 04, 201611:06 AM Subject: Relayed: Approval of site plan Delivery to these recipients or groups is complete, but no delivery notification was sent by the destination server: wcline.fredcogovpc@icloud.com Subject: Approval of site plan • 0 Pam Deeter From: Mail Delivery System <MAILER-DAEMON@AOL.com> To: Greywolfeinc@aol.com Sent: Tuesday, October 04, 201611:07 AM Subject: Expanded: Approval of site plan Your message has been delivered to the following groups: Grevwolfeinc@aol.com Subject: Approval of site plan FREDEG--K COUNTY SANITATION ARITY SITE PLAN REVIEW COMMENTS PO Box 1877, Winchester, VA 22604-8377 540.868.1061 voice 315 Tasker Road, Stephens Ci , VA 22655 �f ,%� 5400.868.1429 fax Project �) �L _—� 12KIKU l��/ C��S�TN4 Applicant 7 tZv-j No REVIEW STATUS attention A review number OZ correct & resubmit roved as noted number of items to be corrected approved ay submit just cover sheet and the revised sheets. DRAWINGS / f /p send me by d v 1 �/1-�' �f &d /0 �tfO'l�j�s 1. print of sheets �J 1� fw 2. two CDs: each disc shall contain a following plan sheets I a) One CD (containing all of the above noted sheets) shall be in PDF format. Each sheet shall be in its own file and be in landscape orientation. Each file shall be titled with the project name and appropriate sheet number. b) One CD (containing all of the above noted sheets) shall be in DWG format. Each sheet shall be in its own file and each sheet shall be titled with the project name and with the appropriate sheet number. Each sheet shall (1) be in landscape orientation, (2) be without border, (3) be in state plane coordinate system NAD 83, and (4) be compatible with AutoCAD 2006. c) Each of the two CDs shall be labeled with its format and project name, and placed in its own paper CD envelope. EASEMENTS �/ N A copy of the recorded onsite-water Qd/oL c x .r easement(s) is/are required. Yo A copy of the recorded offsite water and/or sewer easement(s) is/are required. o The easement document shall contain a plat and both shall be signed by the Authority. o The Authority requires specific language in its deed of easement. o Contact this office to obtain a copy of the form. o A copy of the recorded deed(s) of easement shall be received before service will be authorized. OTHER Y (5 This project also requires DEQ - Valley Region Office approval. Y 162 This project also requires VDH — Lexington Field Office approval. Y his project also requires VDH — Lexington Field Office — Project Summary Report. BY DATE FOR DRAWINGS ABOVE / This project has a sewer pump station that FCSA will own. Title` to the pump station site shall be granted to the Authority in fee simple absolute. Also, (1) a copy of MQ's Certificate to Construct, (2) a copy of DEQ's Certificate to Operate, and (3) two copies of the FCSA' approved 0 & M manual are required. These documents must be received before service will be authorized. Date: • 1A - Earl W. Wiley — Engineering As ' tant h1A)' 2015 COUNTY of FREDERICK Department of Public Works 5401665-5643 FAX: 540/678-0682 September 23, 2016 Mr. Mike Artz Pennoni Associates, Inc. 117 East Piccadilly Street Suite 200 Winchester, VA 22601 RE: Revised Site Plan for Proposed Valley Health Urgent Care Center Frederick County, Virginia Dear Mr. Artz: Your letter dated September 9, 2016 and the associated revised drawings have adequately addressed our previous review comments dated August 15, 2016. Therefore, on behalf of the Frederick County Public Works Department, I grant our approval for the subject site plan. Sincerely, 4-amzc. ttLolc� Harvey E. Strawsnyder, Jr., P.E. Director of Public Works HES/kco cc: Planning and Development file 107 North Kent Street, Second Floor, Suite 200 - Winchester, Virginia 22601-5000 MEMORANDUM TO: Tyler Klein, Frederick County Planning FROM: Mike Artz DATE: September 9, 2016 SUBJECT: Valley Health Urgent Care — Rutherford Crossing Site Plan #29-16 117 East Piccadilly Street Winchester, VA 22601 T: 540-667-2139 F: 540-665-0493 www.pennoni.com J . SEP - g 2016 We have received your comments dated August 23, 2016 and have revised the plans accordingly; one set is attached for your reference. Our specific responses are as follows: 1) Comment: Site Plan Reference. Add the site plan number, SP# 29-16, to all sheets in the plan set. Response: Added site plan reference number to all sheets 2) Comment: Magisterial District. Please add a reference to the Magisterial District, Stonewall, to the cover of the plan set. Response: Added the Magisterial District to the Cover sheet. 3) Comment: Site Area. Please update sheet 2 of 13 to reflect 6.95 acres (total parcel acreage) as indicated in the Frederick County GIS. Response: The total parcel acreage is the same as the site area per the recorded subdivision plat, a copy of which is provided along with these comments. 4) Comment: Subdivision. If this development is planned to be on a separate lot, the plat for the lot needs to be approved and recorded prior to final site plan approval. The site plan should show the new lot layout. Response: A copy of the recorded subdivision plat is provided with these comments. 5) Comment: Previous Approvals. On Sheet 2 of 13 under Site Development Summary please also add a reference to previously approved Site Plans (SP) #13-07, Rutherford Crossing and SP #55-07, Rutherford Crossing — Revisions. Response: Added reference to previously approved Site Plans 6) Comment: Curbs and Gutters. Please revise the plan set to reflect the Zoning Ordinance requirement that all curbing shall be a minimum of six (6) inches in height (revise notes to "Proposed CG-6"). Response: Plan has been revised to call for Turndown Curbing along the sidewalks next to the parking spaces adjacent to the building. A detail has also been added on sheet 13. 7) Comment: Signs. Please provide the location and other details on any proposed business signage on site as consistent with the approved Proffer Statement and Frederick County Zoning Ordinance. One monument sign, not to exceed 50 square feet and 12 feet in height is permitted. Please provide a rendering of the proposed sign within the Miscellaneous Details sheets. Any proposed building mounted signage will be reviewed and approved at time of building permit. Response: No monument signs are proposed. Building mounted signage (if any) will be proposed at the time of building permit. TSTD1601 September 9, 2016 • Page 2 Frederick County Planning Valley Health Rutherford Crossing 8) Comment: Landscape Plan. Please confirm that the existing evergreen trees were not included as part of a landscaping requirement on the original site plan for Rutherford Crossing (SP #13-07). Trees may not be double counted to fulfill planting requirements. Response: To my knowledge the existing evergreen trees were included as part of a landscaping buffer requirement on the original site plan. We are not counting them towards fulfilling our planting requirements. 9) Comment: Outdoor Lighting. Please provide the following revisions to Sheets 11 and 12 of 13, Lighting Plan and Lighting Details: • Please provide a table showing the minimum, maximum and average lighting levels for the site to be evaluated by Staff. As specified in the Zoning Ordinance, a maximum of five (5) foot candles is permitted along road rights -of -way, property lines and for parking lots and loading areas. Response: Provided with this submittal. Please clarify (and add a note to Sheet 11A of 13) that light fixtures, including the mounting base, shall not be more than 25 feet in height above finished grade. It is not clear from the details provided what the height of the poles will be. Response: Height information is provided with this submittal. Existing poles are 35' high and proposed poles are 25' high. • Proposed lighting pole position #6 shall be relocated, as light fixtures shall be placed outside of the paved areas of a site per the Zoning Ordinance. Response: Relocated as requested. Please depict and provide details on any building mounted fixtures. If no building mounted fixtures will be provided, please add a note to this effect. Response: No building mounted fixtures are proposed. Note 10 has been added to Sheet 11. Add a note that all lighting will conform to Section 165-201.07, Outdoor lighting standards, of the Frederick County Zoning Ordinance, and will be full cutoff. Response: Added Note 8 on Sheet 11. 10) Comment: Agency Approvals. Comment sheets (approvals) are required from the following agencies: the Frederick County Inspections Department, the Frederick County Fire Marshal, the Virginia Department of Transportation (VDOT), Frederick County G.I.S., the Frederick County Sanitation Authority (FCSA) and the Frederick County Engineering. Response: Agency Comment sheets are included. 117 East Piccadilly Street Winchester, VA 22601 T:540-667-2139 F: 540-665-0493 www.pennoni.com MEMORANDUM TO: Earl Wiley PE, Frederick County Sanitation Authority FROM: Mike Artz DATE: September 9, 2016 SUBJECT: Valley Health Urgent Care Center Rutherford Crossing CC: Tyler Klein, Frederick County Planning We have received your comments dated August 1, 2016 and have revised the plans accordingly. Our specific responses are as follows: 1. Comment: Hatching differs from other sheets. Response: Hatching has been revised to be consistent on all sheets. 2. Comment: Connect to LIDL water stub (or shorten). Install FH w/valve 5'-10' off. Water service off stub. See LIDL plan. (sketch of proposed connection provided) Response: We changed our plan to agree with your proposal. 3. Comment: Change "Water Easement" wording to "FCSA Easement". Response: Revised as requested. 4. Comment: Consider; only 1" or 2" private water services are allowed. 1" — 5/8 meters then 1" service, 2" —1 %2" meters then 2". See FCSA details for meter box/vault. Response: 1" water service and 1" water meter and box has been chosen for this site. Plans have been updated to reflect this choice. 5. Comment: Adjust existing manhole and fire hydrant to grade per FCSA Inspectors requirements Response: Added note for adjusting the existing manhole. The existing fire hydrant is being completely removed. 6. Comment: Will existing Fire Hydrant work in current location? Response: No. It is being completely removed and returned to FCSA. 7. Comment: Show water and sewer demands. Response: Based on the Virginia Sewage Handling and Disposal Regulations Table 5.1, a doctor's office in medical center will produce approximately 500 gpd per day/ 1000 s.f. The building is approximately 7,800 s.f. so that comes out to 3,900 gpd. Added this information to Site Development Summary on Sheet 2. 8. Comment: Provide correct meter installation detail depending upon chosen meter size. Response: FCSA 1" Meter detail chosen and shown on plans. 9. Comment: Add FCSA details 2, 3, 4, 9 as applicable. Response: Added details 2, 3, and 4. TSTD1601 September 9, 2016 • Page 2 w Frederick County Sanitation Arity Valley Health Rutherford Crossing 10. Comment: Add FCSA notes to Sheet 2 Response: Added FCSA notes to Sheet 2. We have enclosed two sets of revised plans. Please contact us if you have any questions. 117 East Piccadilly Street Winchester, VA 22601 T:540-667-2139 F: 540-665-0493 www.pennoni.com MEMORANDUM TO: Ed Strawsnyder, PE, Director of Public Works FROM: Mike Artz DATE: September 9, 2016 SUBJECT: Valley Health Urgent Care Center Rutherford Crossing CC: Tyler Klein, Frederick County Planning We have received your comments dated August 15, 2016 and have revised the plans accordingly. Our specific responses are as follows: 1. Comment: Refer to Sheet 2 of 12, Erosion Control: Under Note #1, change building inspection to the Department of Public Works. Response: Revised as requested. 2. Comment: Refer to Sheet 3 of 12, Easement Legend: Correct the legend to reflect the cross hatching shown on the plan for the sanitary sewer easement. Response: Revised on all sheets. 3. Comment: Refer to Sheet 3 of 12: The area shown as grass is actually a pre -developed shot rock/clay fill constructed during the initial site development for the Rutherford Crossing. Please provide this office with a copy of the geotechnical report of the fill placement. A copy should also be provided to the building design architect/engineer. Response: A copy of the geotechnical report is enclosed. 4. Comment: Refer to Sheet 4 of 12, Pavement Notes: Provide a detail of the heavy duty pavement section on sheet 12 of 12. Also, it may be beneficial to indicate the travel ways requiring heavy duty pavement using a pavement legend. Response: Detail is provided on Sheet 4 and note has been revised. All the travel ways are required to use the heavy duty pavement section. 5. Comment: Refer to Sheet 4 of 12: Provide a connection detail between the PVC roof drains and the existing concrete storm sewers. Response: Added detail to sheet 13. 6. Comment: Refer to Sheet 4 of 12, Dumpster Pad: Consider specifying rigid pavement in front of the dumpster pad to accommodate the load of the trucks cutting their front wheels and picking up the dumpster containers. Response: Revised note on Sheet 4 to require heavy duty concrete pavement for both the dumpster pad and apron. - TSTD1601 • September 9, 2016 0 Page 2 Frederick County Public Works Valley Health Rutherford Crossing 7. Comment: Refer to Sheet 7 of 12, Project Description: Please provide our office with a copy of the final nutrient credit contract. Response: Provided copies of the exhibits. Documents are being executed and you will receive the completed and signed documents directly from the Virginia Nutrient Bank. We have enclosed one set of revised plans, the Geotechnical Evaluation and the Nutrient Credit Agreement. Please contact us if you have any questions. REQUEST FOR SITE PLAN COMMENTS Frederick County Fire Marshal Comment Mail to: Frederick County Fire Marshal Attm Fire Marshal 1900 C'overstone Drive WIffichester, Virgiitia 22602 Hand deliver to: Public Safety Building 1080 C'overstone Drive Winchester, Virginia 22602 Phonc: (540) 665-6350 Applicant: h is your responsibility to complete this fortis as accurately as possible in orcler to assist the agency with their review. Please attach two (2) copies of the Site flan with this sheet. Applicant's Name:. Pennoni Associates Inc_ Telephone: 540-667-2139 Attn: Mike Artz Failing Address: 117 E. Piccadilly Street Suite 200 Winchester. VA 22601 Name of development and/or description of the request Vallev Health Uroent Care Center Location of Property: Tax Map 43-A-100F - Located at southeastern intersection of Merchant and Market Streets at Rutherford Crossing Fire Marshal Comments: i...,.__.. — . _.--.... f-FREDERICK C'O(JNTV FIRL: NIARSIIAL USE: OQNLY- ` DILIv Received � ^ Review Numbed_' 3 a 5 (circle one) i Date Reviewed R.evision Required Dale Approved i4 Z2A 1 Signature a Date: * kleme Return Form to Applicantxx 20 RECEIVED JUL 2 1 Frederick County Department of Fire and Rescue Office of"the Fire Marshal 1080 C oversturie Drive if rrichester, VA 22602 (540) 665-6350 Fax. (540) 678-4739 Email: jmaVcvmtts• Plan Review & Comments Date Received 7)2112016 Plan/Permit Type site Plan 07-21-16 Name Valley Health Urgent Care Center Address Merchant SUMarket St Project Name Applicant Name & Number RE# Permit Number Date Reviewed 81212016 Winchester VA 22602 Site Plan 07-21-16 Pennoni Associates, Inc. 540-667-2139 Emergency Vehicle Access: Adequate Inadequate NIA Hydrant Location: Adequate Inadequate NIA Siamese location. Adequate Inadequate N/A Fire Lanes Required: Yes No N/A Plan Approval Status Approve Comments Site Approved, provided that the fire lane striping and sign age changes have been met. Signature: Reviewed By: Kenneth Scott, Jr. Title: f REQUEST FOR SITE PLAN COMMENTS Request for Street Name Comment Mail to: Hand deliver to: Frederick County Frederick County information Technologies, GIS Division information Technologies, GIS Division Attn: GIS Manager 107 North Kent Street, 1" Floor 107 North Kent Street, Winchester, Virginia 22601 Winchester, Virginia 22601 Phone: (540) 665-5614 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 Applicant's Name: Pennoni Associates Inc. Attw Mike Artz Mailing Address: 117 E. Piccadilly Street Suite 200 Winchester, VA 22601 Name of development and/or description of the request: Valley Health Urqent Care Center Telephone: 540-667-2139 Location of Property: Tax Map 43-A-100F - Located at southeastern intersection of Merchant and Market Streets at Rutherford Crossi GIS Manager Comments: Nn K�� S-%rtG'� ►ili�^4S (�C�.a%/`ca.. rt..� art •c — New r-V .ANixs-s_ 1(n0 <ST -ass,►-��. �" .�C J P"z e, t Pl - y3 - A - tooF K4- 4._ ,V -GIS MANAGER USE ONLY - Date Received Ci / " 4 Review Numbe&2 3 4 5 (circle one) Date Reviewed Revision Required Date Approved Signature & Date:_�� ** Please Return Form to Applicant** 17 0 0 E-911 STRUCTURE NUMBER NOTIFICATION Please be advised that a residence or business that you own or occupy has ¢ been assigned a structure number for the E-911 system. �7 PIN: 43-A-100F (This PIN (Parcel Identification Number) refers to the property on which the structure is located. If you own more than one property, check your tax bills for correct PINs and make sure that this is the correct property involved.) STRUCTURE NUMBER: 160 ROAD NAME: MERCHANT ST DATE: Aug 26, 2016 (CUT AND RETAIN THIS PORTION OF TI IE NOTIFICA'11ON FOR YOUR RECORDS) (RF:'rURN-PHIS C'OMPI.IS'1'1:D PORTION OF THE NOTIFICATION TO'rlll: GIS DEPARTMENT) CURRENT MAILING ADDRESS: RUTHERFORD FARM LLC C/O NV RETAIL MICHELLE WASSERMAN 8230 LEESBURG PIKE STE 620 VIENNA, VA 22182 PHONE NUMBER: PIN: 43-A-100F STRUCTURE NUMBER: 160 DATE: Aug 26, 2016 ROAD NAME: MERCHANT ST Please complete one of the listings below. Complete information will enhance service to you. I own and occupy the structure referenced above. Follow the requirements for displaying the new structure number. I own and will be renting out the property You are responsible for notifying the occupant of the structure number. Indicate name and current mailing address of occupant. The property is under construction and I will occupy when complete. The property is under construction and I will be selling when complete. I occupy the structure referenced above, but do not own it. Contact the owner and coordinate the displaying of the new structure number. Please indicate the property owners name: The property owners address: For County of Frederick requirements, please see: the County of Frederick Code Website: http://ecode360.com/8705401 NOTE: If you have not checked any of the boxes or require special assistance, please call the GIS Department at (540)665-5614. Refer to this form. Please complete and return this form within fourteen (14) days to the Frederick County GIS Department. Your time and assistance are essential to operation of the E-911 system. Failure to comply may inhibit emergency response. FREDERICK COUNTY INFORMATION TECHNOLOGIES & GIS 107 North Kent Street, Winchester, VA 22601 (540)665-5614 - E-mail pfly@coArederick.va.us Ree num: 8046857 U 0 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 Hand deliver to: Frederick County Inspections Dept. 107 North :Kent Strcet, 2nd Floor Winchester, Virginia 22601 Phone: (540) 665-5650 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. Applicant's Name: Pennoni Associates Inc. Telephone: 540-667-2139 Attn: Mike Artz Mailing Address: 117 E. Piccadilly Street Suite 200 Winchester, VA 22601 Name of development and/or description of the request: Valley Health Urgent Care Center Location of Property: Tax Map 43-A-100F - Located at southeastem intersection of Merchant and Market Streets at Rutherford Crossing Department Comments: -FREDERICK COUNTY INSPECTIONS DEPARTMENT USE ONLY - Date Received *—//Z: f Review Numbeto 2 3 4 5 (circle one) Date Reviewed 2� Revision Required_ . Date Approved Signature & Date: A1ZLl L ** Please Return Form to Applicant** 18 • 0 Building shall comply with The Virginia Uniform Statewide Building Code and Section 304 Business of the International Building Code/2012. Other codes that apply are ICC/ ANSI A117.1-2009 Accessible and Usable Buildings and Facilities and Virginia Energy Code 2012. Building shall maintain height and area as required under T503 with allowable increases. All required exits shall be accessible. All public entrances shall be accessible and comply with the 2012 Virginia Energy Code. Maximum threshold at doorways shall not exceed %s". One main public entrance and one employee entrance provided — both meet ANSI A117.1-09 Van accessible and accessible parking and unloading shall be provided as required per Table 1106.1. Van accessible parking spaces shall measure 8' in width with an 8' unloading area or I V parking width with a 5' unloading area. . Accessible parking signage for van shall include $500 fine. See USBC Section 1106.8 for van signage. Curb ramps shall meet ANSI A117.1-09 for slope. Max slope of walkway 5%, maximum slope of landings is 2%. Max slope of ramps is 1:12 or 8.33% Please note the requirements in Chapter 17 of USBC/IBC for special inspection requirements on the type of structure ( Soils, concrete etc.) Compaction/soil bearing/soil testing shall be required for placement of new facility. A geotechnical evaluation shall be performed and submitted with application as required USBC/IBC Section 1803. E Karen Flynn From: Mike Artz Sent: Tuesday, September 06, 2016 9:39 AM To: Karen Flynn Subject: FW: Valley Health, Rutherford Crossing Site Plan Review Mike Artz Pennon! 117 East Piccadilly Street I Winchester, VA 22601 Direct: 540-771-2092 www.pennoni.com I martz(&Pennoni.com From: Rhodes, Timothy (VDOT) rmailto:Timothy.Rhodes@)vdot.virginia.gov] Sent: Tuesday, September 06, 2016 9:37 AM To: Mike Artz Cc: Funkhouser, Rhonda (VDOT); Smith, Matthew, P.E. (VDOT); 'Candice Perkins'; Hoffman, Gregory (VDOT) Subject: Valley Health, Rutherford Crossing Site Plan Review Mike, We have reviewed the proposed Valley Health, Rutherford Crossing Site Plans with a signature date of July18,2016. The proposed facility will be located on a private property not maintained by VDOT. The entrance connections for the development as well as the frontage improvements have been previously installed to satisfy the needs of this Site Plan, therefore, we have no overall objection to this proposed use. Should you have any questions, please feel free to contact me. Thank You, Timothy Rhodes VDOT—Land Development Engineer Clarke, Frederick, Shenandoah & Warren Counties 14031 Old Valley Pike Edinburg, VA. 22824 (540)-984-5630 0 160008770 c-� C� C_• THIS DEED OF SUBDIVISION, made and dated thisday of September, 2016, by RUTHERFORD FARM LLC, a Virginia limited liability company, Grantor and Grantee for indexing purposes. RECITALS: R-1. The Grantor/Grantee is the owner in fee simple of that certain tract of land containing 69525 acres situate in Stonewall Magisterial District, Frederick County, Virginia, designated as Lot I -B, PIN 43-A-100F (the "Parent Tract"), on that certain Boundary Line Adjustment Plat dated as of March 9, 2016, recorded in the Office of the Clerk of the Circuit Court of Frederick County, Virginia, as Instrument No. 160003149 (the `BLA Plat"), and being generally shown on Sheet 2 of 4 of the "Plat of Subdivision Lot 1-B — Rutherford Farm, LLC" drawn by P. Duane Brown, L.S., dated August 4, 2016, attached hereto and recorded herewith (the "Subdivision Plat"). R-2. As specifically shown on Sheet 3 of 4 of the Subdivision Plat attached hereto, the Parent Tract is hereby being subdivided into the following lots: Lot 1-B, PIN 43-A-100F, containing 5.4390 acres; and Lot 1-C, PIN 43-A-100M, containing 1.5135 acres. R-3. Sheet 3 of 4 of the Subdivision Plat attached hereto further shows and describes a shaded area designated thereon as "EXISTING INGRESS -EGRESS EASEMENT INST. 160006707," which easements exist on Lot I -B created hereby. All easements, rights and obligations created and effected by Instrument No. 160006707 are unaffected by this Deed of Subdivision. R-4. Grantor/Grantee desires to subdivide the Parent Tract into Lot 1-B and Lot 1-C. as set forth herein. 1. SUBDIVISION/DEED OF SUBDIVISION NOW, THEREFORE, THIS DEED OF SUBDIVISION WITNESSETH: That for and in consideration of the premises and the benefits which will accrue by reason of this Deed, Grantor/Grantee 0 c7 CD CD 0, CJ I does hereby subdivide the Parent Tract into Lot I -B containing 5.4390 acres and Lot 1-C containing 1.5135 acres, both of such Lots being more particularly described on the attached Subdivision Plat. The subdivision of land as shown on the attached Subdivision Plat is with the free consent and in accordance with the desire of the Grantor/Grantee, being the owner and proprietor of the land being subdivided, and is in conformity with the provisions of law as are applicable, together with the applicable ordinances and regulations of the governing body of the County of Frederick, Virginia. The County of Frederick, Virginia consents to the subdivision of the land as set forth on the Subdivision Plat, all as evidenced by its execution of the attached Subdivision Plat. 11. EASEMENTS AND RIGHTS UNAFFECTED This Deed of Subdivision does not modify, diminish or affect the existing easements designated as "EXISTING INGRESS -EGRESS EASEMENT INST. 160006707" on the attached Subdivision Plat or the "EXISTING EASEMENTS AND ENCUMBRANCES" shown and described on Sheets 4 and 5 of the above -referenced BLA Plat, all of which easements and encumbrances remain in effect. WITNESS the following signature and seal: RUTHERFORD FARM, LLC, a Virginia limited liability company By: NVRETAIL, INC., a Virginia corporation, Its Manager COMMONWEALTH OF VIRGINIA, City of Winchester, to -wit: (SEAL) The foregoing instrument was acknowledged before me on the _ I _ day of September, 2016, by in his/her capacity as 1}ct� %eQoeon behalf of NVRETAIL�anager of Rutherford Farm, LLC, a Virginia limited liability company. Cap'%,, • NOTARY'• G PUBLIC : Notary Public REG. #244591 = MY COMMISSION : a' '. EXPIRES Qy 01/31/2020 _: A. a. • 0 My Commission Expires: Ut w . s / . ?Z) .7t, Notary Registration No.: IF -04 S ,?/ This instrument was prepared (without the benefit of a title examination) by: H. Edmunds Coleman,111, Esq. BRYAN &c COLEMAN, P.L.C. 118 South Braddock Street Winchester, Virginia 22601 Telephone: (540) 545 — 4172 Facsimile. (540) 545 — 4173 L:1Rutherford Farm, LLC (Deed of Subdivison)\Deed of Subdivision (final) 9-7-16.doc �a yGB A C � �'•�i _ MNOTARY YPUBL %• 01/31120 fo .0 IF • 0 SITE 14CINITY MAP SCALE- I" = 3000' APPROVED BY -/41-2e/6 PIRG/N/A DEP RIME OF AN ORTA W DATE i Au 2014 FREDERICK COUNTY SANITA ON AUTHORITY DATE B I CIS/ON ADMINISTRATOR DA OWNERS CERTIRCA TE THE ABODE AND FOREGOING SUBD/NSION OF LOT 1-B - RUTHERFORD FARM, LLC [PIN 43-A-IOOF] AS APPEARS IN THE ACCOMPANYING PLATS; lS WITH THE FREE CONSENT AND /N ACCORDANCE 91TH TH£ DESIRES OF THE UNDERSIGNED OWNERS, PROPRIETORS AND 7RU57EES, IF AN 0,141 1 to ,%, �( ••a• �� • e N...... BE ALF 0 RUTHER LLC NOTARY PUBLIC i - MY o RES1O Z►; N TARY PUBLIC oiav2o2o ;� ; STATE OF l RGIN/ AT LARGE a ALTN COUNTY OF _ THE FOR O/NI� lNS U N WAS ACKNOWLEDGED BEFORE ME THIS ..?q DAY OF , 20J6 BY ' ON BEHALF OF RUTHERFORO FARM NOTARY PUBLIC MY COMMISSYGW EXPIRES o20 SURVEYOR'S CERTIFICATE / HEREBY CERTIFY THAT THE PROPERTY [PIN 43-A-100F] REPRESENTED HEREIN IS A PORTION OF THE PROPERTY CONVEYED TO RUTHERFORD FARM, LLC BY DEED DATED MARCH 23, 2005 AND /S SHOWN AS LOT 1-8 ON A PLAT DATED MARCH 9, 2016, SAID DEED AND PLAT RECORDED IN THE OFFICE OF THE CLERK OF THE CIRCUIT COURT OF FREDERICK COUNTY, 14RGINIA AS INSTRUMENT 050006702 AND INSTRUMENT 160003149, RESPEC770 Y. NUES: 1. BOUNDARY INFORMATION IS BASED ON AN ACTUAL FIELD SURREY COMPLETED AUGUST 2, 2016. 2. THIS PROPERTY [PIN 43-A-100FJ /S SUBJECT TO EXISTING EASEMENTS AND ENCUMBRANCES AS RECORDED IN DEED BOOK 700 AT PAGE 875, DEED BOOK 720 AT PAGE 140, INSTRUMENT 070011052, INSTRUMENT 070016050, INSTRUMENT 070016051, INSTRUMENT 080000920, INSTRUMENT 080005730, INSTRUMENT 090002932 AND INSTRUMENT 110005361. OTHER EASEMENTS OR ENCUMBRANCES, IN ADD/TION TO THOSE REFERENCED, MA Y EXIST. PLA T OF SUBDIVISION � �,TH OF y LOT 1-8 N RUTHERFORD FARM, LLC STONEWALL MAGISTERIAL DISTRICT o re,� f FREDERICK COUNTY, VIRGINIA P. Duane Brown Lic. No. 001285 Al ¢, 2oI& AND DATE.• AUGUST 4, 2016 COkER SHEET SHEET 1 OF 4 Marsh & Legge Land Surveyors, P.L.C. 560 NORTH LOUDOUN STREET - WINCHESTER, VIRGINIA 22601 DRAWN BY HBK PHONE (540) 667-0468 - FAX (540) 667-0469 EMAIL office®marshandlegge.com DWG NAME 198259—Lot 18-5U5 • Pi J VA. SEC R7F fiOR MARKET RRETT (VARIABLE WIDTH RA) PAV 45-A-IMr LOT 1-B ZONED.- 8-2 USE VACANT 6.9525 ACRES PIN 43-A-100 LOT 1-A RUTHERFORD FARM, LLC INST. 160003149 ZONED.- B-2 USE.• VACANT EXISTING PROPERTIES PIN 43--A-99 C. ROBERT SOLENBERGER, ET ALS lNST. 080002993 ZONED.- M-1/8-2 USE VACANT PIN 43C-1—A ROY R. MESSICK DB 259 PG 568 ZONED.- RP USE RESIDEN77AI GRAPHIC SCALE 200' 0 100' 200' 400' 1 inch = 200 ff. PLA T OF SUSDI VISION LOT 1—B N RUTHERFORD FARM, LLC STONEWALL MAGISTERIAL DISTRICT FREDERICK COUNTY, VIRGINIA DATE.• AUGUST 4, 2016 1 SCALE- 1" = 200' 1 SHEET 2 OF 4 1 Marsh & Legge Land Surveyors, P.L.C. 560 NORTH LOUDOUN STREET — WINCHESTER, VIRGINIA 22601 PHONE (540) 667-0468 — FAX (540) 667-0469 EMAIL office®marshandlegge.com Lyj of o f� �,vvr 9 P. Duane Brown Lic. No. 001285 Avg . ,4, 2o�C L4ND SUvV0, V DRAWN BY HBK DWG NAME I08259—Lot 19-51/91 • FOR L4 06 L5 N 4278:30" E C71RF 147J, ' IRF ,— -__ 84.8,3 5 625�51 BNS IRS ' Szi h PIN 43-A-100M LOT 1-C t4 14, ZONED.- 8-2 USE VACANT ,cav PKF 1.5135 ACRES 10.28' IRS r 1 19 I S 4278'4A" W ?tldt85' lRF N 427830" £ 277.81' 35' BRL PIN 43-A-100F LOT 1-B ZONED.- 8-2 USE VACA, 5.4390 ACRES 4— — — _ _ _ ?74 47' ` ' IRF I N 4278'30' £ 327.08' (T01,4 I � j '*4 EXISTING �I .I �I �D4F PIN 4.3-A-100F LOT 1-B PKF' ZONED.- 9-2 USE.- VACANT 5.4390 ACRES I� Im I I I I I l 0. PKF LEM � 26. IRF - IRON ROD FOUND >9 PKF - P-K NAIL FOUND DHF - DRILL HOLE FOUND IRS - IRON ROD SET BNS - BRICK NAIL SET BRL - BUILDING RESTRICAON LINE INGRESS -EGRESS IRF � I EASEMENT IRF INST. 160006707 to PIN 43-A-100 LOT 1-A lRf ZONED.• 8-2 USE VACANT " Xffgh 1 . IRF S .S9 1,2?fir, c9 01(TOTAL� AREA SUMMARY LOT 1-13 5.4390 ACRES LOT 1-C 1.5135 ACRES TOTAL AREA SUBDIVIDED 6.9525 ACRES IRF SEE SHEET 4 OF 4 FOR LINE AND CURVE TABLES GRAPHIC SCALE 100' 0 50' 100' 200' 1 inch = 100 ft. PLA T OF SUBDIVISION LOT 1-B - RUTHERFORD FARM, LLC STONEWALL MAGISTERIAL DISTRICT FREDERICK COUNTY, VIRGINIA DAIE AUGUST 4, 2016 SCALE 1 " = 100' SHEET 3 OF 4 Marsh & Legge Land Surveyors, P.L.C. 560 NORTH LOUDOUN STREET - WINCHESTER, VIRGINIA 22601 PHONE (540) 667-0468 - FAX (540) 667-0469 EMAIL off ice®marshandlegge.com ,1,LTH OF D � n � P. Duane Brown Lic. No. 001285 AND 3UR1F'`Zo DRAWN BY HBI( DWG NAME ID8259-L of 19-SU8 CURW TABLE CURD£ RADIUS ARC LEN07H CHORD BEARING CHORD LENGTH DELTA maf TANGENT C1 2466.00' 320.90' S 485730" W 320.68' 077721 " 160.68' C2 440.22' 29.33' N 491626" W 29.33' 03'49'04" 14.67' C3 99.00, 13. 44' N 434874" W 13.43' 0746'33" 6. 73' C4 1 108.00' 14.66' N 4348'14" W 14.65' 0746W" 7.34' C5 93. 00' 146. 08' N 02 41'30" W 131.52' 90t70 00" 9100' C6 100.00' 11.94' N 4543'47" E 1494' 0650;34" 5.98' C7 100.00' 11.94' N 454347" E 11.94' 0650:14" 5.98' C8 2466.00' 88.24' S 4675'19" W 88.23' 02t73'00" 44.12' C9 2466.00 232.66' S 4959'00" W 232.58' 052421" 116.42' CIO 130.00' 9.26' S 493076" E 9.26' 04V458" 4.63' C11 45.00' 1.08' S 5051;33" E 1.08' 1 012223" 1 0.54' C12 15.00' 23.56' S 024120" E 21.21' 1 90w'00" I15.00' LINE TABLE LINE BEARING DISTANCE L 1 S 83'22'46" W 36.70' L2 N 46'55'18" W 37.20' L3 S 42'18;30" W 2.40' L4 N 42'18;30" E M..64' L5 N 49'09'04" E 67.78' L6 N 47'41330" W 9.50' L7 S 472747" E 78.38' L8 S 565532" E 25.00' L9 S 5248'00" W 25.00' PLA T OF SUBDIVISION ! TH Op LOT 1-B - RUTHERFORD FARM, LL C STONEWALL MAGISTERIAL D157RICT FREDERICK COUNTY, VIRGINIA MD"uda Lic. No. 001285 PAY- AUGUST 4, 2016 I I SHEET 4 OF 4 Marsh & Legge Land Surveyors, P.L.C. 560 NORTH LOUDOUN STREET - WINCHESTER, VIRGINIA 22601 PHONE (540) 667-0468 - FAX (540) 667-0469 EMAIL off ice®marshandlegge.com zcico4 0 N SURN�� DRAWN BY.• HBl( DWG NAME 108259-Lot 19-50 • LJ z� C.: C:� v I RGIN1A: FK--"DER[CK COUNTY.SUI . This instrument of writing was produced to me on Q - 00' - ZOAP at __ \ b ' 15 $m and with certificate acknowledgement thereto annexed was admitted to record. Tax imposed by Sec. 58.1-802 of $ UI , and 58.1-801 have been paid, if assessable 4&e4 to , Clerk OFFICIAL RECEIPT FREDERICK CIRCUIT COURT DEED RECEIPT DATE: 09/08/16 TIME: 10:25:17 ACCOUNT: 069CLR160008770 RECEIPT: 16000017417 CASHIER: KJS REG: WE17 TYPE: DV-PL PAYMENT: FULL PAYMENT INSTRUMENT 160008770 BOOK: PAGE: RECORDED: 09/08/16 AT 10:25 GRANTOR: RUTHERFORD FARM LLC EX: N LOC: CO GRANTEE: RUTHERFORD FARM LLC EX: N PCT: 100% AND ADDRESS : RECEIVED OF : FIRST BANK/BRYAN & COLEMAN DATE OF DEED: 09/07/16 CHECK: $21.00 DESCRIPTION 1: ST DIST (05-6702) PAGES: 5 OP: 0 2: NAMES: 0 CONSIDERATION: .00 A/VAL: .00 MAP: MISC PIN: ,•301' DEEDS 14.50 145 VSLF 1.50 `. 106 TECHNOLOGY TRST FND 5.00 '� TENDERED 21.00 AMOUNT PAID: 21.00 CHANGE AMT : .00 CLERK OF COURT: REBECCA P. HOGAN PAYOR'S COPY / RECEIPT COPY 1 OF 2 4V COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 August 23, 2016 Michael M. Artz Pennoni Associates Inc. 117 East Piccadilly Street Winchester, VA 22601 Re: Review Comments for Site Plan #29-16; Valley Health Urgent Care — Rutherford Crossing Property Identification Number (PIN): 43-A-100F Dear Mr. Artz: 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 Staffs comments listed below and then prepare a revised site plan which adequately addresses each concern. Review Comments: 1) Site Plan Reference. Add the site plan number, SP# 29-16, to all sheets in the plan set. 2) Magisterial District. Please add a reference to the Magisterial District, Stonewall, to the cover of the plan set. 3) Site Area. Please update Sheet 2 of 13 to reflect 6.95 acres (total parcel acreage) as indicated in the Frederick County GIS. 4) Subdivision. If this development is planned to be on a separate lot, the plat for the lot needs to be approved and recorded prior to final site plan approval. The site plan should show the new lot layout. 5) Previous Approvals. On Sheet 2 of 13 under Site Development Summary please also add a reference to previously approved Site Plans (SP) #13-07, Rutherford Crossing and SP #55-07, Rutherford Crossing — Revisions. 6) Curbs and Gutters. Please revise the plan set to reflect the Zoning Ordinance requirement that all curbing shall be a minimum of six (6) inches in height (revise notes to "Proposed CG-6"). 7) Signs. Please provide the location and other details on any proposed business signage on site as consistent with the approved Proffer Statement and Frederick County Zoning Ordinance. One monument sign, not to exceed 50 square feet and 12 feet in height is permitted. Please provide a rendering of the proposed sign within the Miscellaneous Details sheets. Any proposed building mounted signage will be reviewed and approved at time of building permit. 107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000 Re: SP #29-16; Valley Health Urgent Care — Rutherford Crossing August 23, 2016 Page 2 8) Landscape Plan. Please confirm that the existing evergreen trees were not included as part of a landscaping requirement on the original site plan for Rutherford Crossing (SP #13-07). Trees may not be double counted to fulfill planting requirements. 9) Outdoor Lighting. Please provide the following revisions to Sheets 11 and 12 of 13, Lighting Plan. and Lighting Details: • Please provide a table showing the minimum, maximum and average lighting levels for the site to be evaluated by Staff. As specified in the Zoning Ordinance, a maximum of five (5) foot candles is permitted along road rights -of -way, property lines and for parking lots and loading areas. • Please clarify (and add a note to Sheet I I A of 13) that light fixtures, including the mounting base, shall not be more than 25 feet in height above finished grade. It is not clear from the details provided what the height of the poles will be. • Proposed lighting pole position #6 shall be relocated, as light fixtures shall be placed outside of the paved areas of a site per the Zoning Ordinance. • Please depict and provide details on any building mounted fixtures. If no building mounted fixtures will be provided, please add a note to this effect; and • Add a note that all lighting will conform to Section 165-201.07, Outdoor lighting standards, of the Frederick County Zoning Ordinance, and will be full cutoff. 10) Agency Approvals. Comment sheets (approvals) are required from the following agencies: the Frederick County Inspections Department, the Frederick County Fire Marshal, the Virginia Department of Transportation (VDOT), Frederick County G.I.S., the Frederick County Sanitation. Authority (FCSA) and the Frederick County Engineer. 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 and at least five (5) copies of the final plan 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: Valley Health, 1836 Amherst Street, Winchester, VA 22601 0 • 2. SITE PLAN APPLICATION - Office Use Only- `2 _ Date Application Received: rr l (I Application #: (p Fees Received:' �, 4,, M-1 Receipt #: C� ;R% Initials: Project Title: Valley Health, Rutherford Crossing Location of Property (Street address) Southeastern intersection of Merchant and Market Streets at Rutherford Crossing 3. Applicant/Designer: Name: Pennoni Associates Inc. Not Assigned Address: 117 E. Piccadilly Street, Suite 200 Winchester, VA 22601 4. Property Owner (if different than above): Name: Rutherford Farm LLC c/o NV Retail Address: 8230 Leesburg Pike, Suite 620 Vienna, VA 22182 5. Property Information: a. Property Identification Number: b. Total acreage of the parcel to be developed C. Total disturbed area of the parcel: d. Present Use: e. Proposed Use: f. Magisterial District(s) Telephone: 540-667-2139 Telephone: 703-448-4311 43-A-100 F 1.52 acres 1.33 acres Vacant Urgent Care Facility Stonewall 0W1N a AUG 1 7 2016 y ®� FREDERICK CCLJN' ' �' ^l-ANNING AND DF. VFI� 1 1 [9 `JT • • 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 II✓ No Yes No Yes II No 7 a. Current Zoning: B2 b. Was this property Rezoned? Yes o No c. If yes provide the rezoning number for this property: 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 Commercial Commercial Commercial Commercial . es es No No M ZONING B2 B2 B2 B2 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: 9 Special Limited Power of Attorney o County of Frederick, Virginia Frederick Planning Website: www.fcva.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) I (Name) Rutherford Farm LLC'clo NV,Retail ! ! � ) (Phone) 703-448-4311 (Address) 8230 Leesburg Pike, Suite 620, Vienna, IVA 22182 I 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 !I Instrument No. 108005730 , on�Page I 1 ' and is described as Tax Map ID: 43-A-100F I I do hereby make constitute and appoint: i , (Name) Pennoni Associates Inc. I I I (Phone) 540-667-2139 I � ' (Address) 117 E. Piccadilly Street Suite 200, Winchester, VA 22601 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:, I _Rezoning (including proffers) ! .Conditional Use Permit �Master,Development Pli in (Preliminary and Final) _[✓Subdivision Site Plan I , _Varian; a or Appeal I � My attorney -in -fact shall have the authority to offer!pioffered conditions and to make amendments to previously approved proffered conditions except as foilows: j This authorization shall expire one year from:the day, it is signed, ,or until it ids otherwise resc n0d,gt"t Q!Qed. In witness thereof, I (we) have hereto my (our) hanFd and seal this gep day of ��G A. ' ' p a Signature(s) I , It •f NOTARY I P 0.0244591 _ W COMMISSION: a State of irgim , City/County of r 2� ! To -wit: _ = EXPIRES o 158 s s 01/31/2020 r a Notary Public in and for theb� �" Ilf"''••��id, certify that a 'person(s) who; signed to the foregoing ,instrument personally appeared b��l?o � o114n%d has acknowledged the same before me in the jurisdiction 'aforesaid ihi's go day of % 20�. i ! J,1 .1 1 My Commission Expires: No ublic 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. Applicant's Name: Pennoni Associates Inc. Telephone: 540-667-2139 Attn: Mike Artz Mailing Address: 117 E. Piccadilly Street Suite 200 Winchester, VA 22601 Name of development and/or description of the request: Valley Health Urgent Care Center Location of Property: Tax Map 43-A-100F - Located at southeastem intersection of Merchant and Market Streets at Rutherford Crossing Department of Planning & Development Comments: Date Received _ Date Reviewed _ Revision Required Signature & Date: -PLANNING DEPARTMENT USE ONLY - Review Number 1 2 3 4 5 (circle one) Date Approved ** Please Return Form to Applicant** 16 `/ ennol PENNONI ASSOCIATES INC. CONSULTING ENGINEERS 117 East Piccadilly Street Winchester, VA 22601 Tel: 540 — 667 - 2139 Fax: 540 — 665 - 0493 LEWR OF TRANSMITTAL TO: Frederick County Planning 107 N. Kent Street r Winchester, VA 22601 - J AUG 1 7 2016 iT DATE I August 17, 2016 JOB NO. I TST61601 ATTENTION I Candice Perkins RE: I Valley Health Rutherford Crossing WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via ❑ Shop Drawings ❑ Prints ❑ Plans ❑ Copy of Letter ❑ Change Order ❑ ❑ Samples the following items: ❑ Specifications LIST OF ITEMS TRANSMITTED COPIES DATE NO: DESCRIPTION 1 Site Plan Application 1 Application Fee in the amount of $2,766 1 Power of Attorney 1 Request for Site Plan Comments 2 Site Plan THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ® For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: Mike Artz, LS 3B If enclosures are not as noted, kindly notify us at once. TR8100 112013 0 • 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 YOU WOULD LIKE TO HAVE COMPLETED. Initials Date & Time Candice N2 MC � L, Mark Dave Tyler Mike John COMMENTS: Received by Clerical Staff (Date & Time): (S:Office on Blackbox\Forms\Document Approval Form —6/7/2016 )