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Home My WebLink About12-18 The Camp of Faith Church PIN 86-A-72 - Opequon - Backfile (2)SITE PLAN TRACKING SHEET Comment Sheets: GIS VDOT Frederick Water 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: y 3 I File Opened �J31 I k Reference Manual updated/number assigned D-base updated (g Scan documents to Planning S: drive y Application Action Summary updated Scan additional items as needed (Project Planner to direct) .CLOSE FILE: I Approved (or denied) letter mailed to applicant/copy to file and cc's File stamped "approved", "denied" or "withdrawn" 3 1 's Reference Manual updated D-base updated Scanning updated l Application Action Summary updated Sys ID # DATE -1 RECEIVED ADDRESS WIN ACCOUNT HOW PAID BEGINNING BALANCE MOUNT -!CASH CHECK BALANCE MONEY DUE ORDER BY C2001 li®IFORMO S1657N-CL COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 May 17, 2018 Jerry Herbaugh The Camp at Faith Church 635 Double Church Road Stephens City, VA 22655 Re: Approval for Minor Site Plan #12-18, The Camp at Faith Church - Shelter Property Identification Number (PIN): 86-A-72 Dear Mr. Herbaugh: The above -referenced minor site plan was approved on May 15, 2018. The minor site plan is approved for a 1,600 SF outdoor pavilion at The Camp at Faith Church in the RA (Rural Areas) Zoning District the Opequon Magisterial District. All requirements of the Frederick County Zoning Ordinance have been met in the approved site plan, including review agency comments from all relevant review agencies. I am providing you with 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: Robert W. Wells, Opequon District Supervisor Roger Thomas and Robbie Molden, Opequon District Planning Commissioners Jane Anderson, Real Estate Commissioner of Revenue The Camp at Faith Church, 635 Double Church Road, Stephens City, VA 22655 107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000 d FREDERICK WATER FREDERICK WATER a SITE PLAN REVIEW COMMENTS PO Box 1877, Winchester, VA 22604-8377 540.868.1061 voice 315 Tasker Road, Stephens City, VA-22655 540.868.1429 fax Project LA ` Applicant /" 1 L l IJ { 7> 5 l L'JA v REVIEW STATUS ) attention review number 61 / correct & resubmit pproved as noted number of items to be corrected approved u may submit just cover sheet and the revised sheets. DRAWINGS send me by 1. print of sheets 2. two CDs: each disc shall c ntain the following plan sheets 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 shall be in DWG format; (1) in Model Space, (2) in state plane coordinate system NAD 83, (3) 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 OTHER Y / F A copy of the recorded onsite FW easement(s) is/are required. Y / N A copy of the recorded offsite FW easement(s) is/are required. o The easement document shall contain a plat and both shall be signed by the Frederick Water. o The Frederick Water requires specific language in its deed of easement. o Visit our website www.frederickwater.com 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. Y / V This project also requires DEQ - Valley Region Office approval. Y / I This project also requires VDH - Lexington Field Office approval. Y / I This project also requires VDH - Lexington Field Office - Project Summary Report. BY DATE FOR I DRAWINGS ABOVE, see VDH website for form Y / This project has a sewer pump station that FW will own. Title to the pump station site shall be granted to the Frederick Water in fee simple absolute. Also, (1) a copy of DEQ's Certificate to Construct, (2) a copy of DEQ's Certificate to Operate, and (3) two copies of the FW approved O & M manual are required. These documents must be received before service will be authorized. (4) Work cannot commence that would connect to FW facilities or require FW inspections until the contract is returned I)-Ar. hiis office.� /j �Date: 'J IN a bV l��/ ,X V Earl W. Wiley - Engineerifig Assistant JAN 18 RECEIVED APR 0 2018 REQUEST FOR CONDITIONAL USE PERMIT COMMENTS Frederick County Fire Marshal Mail to: Frederick County Fire Marshal 1800 Coverstone Drive Winchester, Virginia 22602 (540) 665-6350 Hand deliver to: Frederick County Fire & Rescue Dept. Attn: Fire Marshal Public Safety Building 1800 Coverstone Drive Winchester, Virginia Applicant: It is your responsibility to complete this form as accurately as possible in order to assist the agency with their review. Also, please attach two (2) copies of your application form, location map and all other pertinent information. r,✓r� (^ Applicant's Name: / // (! ��P o `C` Telephone Mailing Address: % 3 O vb l e C �,, , f, h .2 L- Name of development and/or description of the request: Location of Property: Fire Marshal's Comments: Fire Marshal's Signature & Sys - � -6 r -e 7 Notice to Fire Marshal - Please Return This Form to the Applicant 11 • Frederick County Department of Fire and Rescue Office of the Fire Marshal 1080 Coverstone Drive Winchester, VA 22602 (540) 665-6350 Fax: (540) 678-4739 Email: fmoWcva.us Plan Review & Comments Date Received 4/3/2018 Plan/Permit Type Conditional Use Permit 04-03-18 Name The Camp of Faith Church Address 635 Double Church RD Stephens City Project Name New Shelter Applicant Name & Number The Camp of Faith Church 540-869-0497 RE# Permit Number Emergency Vehicle Access: Adeofiate Inadequate N/A Hydrant Location: Ademiate Inadequate N/A Siamese Location: Adequate Inadequate l Fire Lanes Required: Yes No �17A Plan Approval Status Approve Comments CUP provided that a 2A:10BC multi -purpose fire extinguisher be hung and tagged in the pavilion Signature: Reviewed By: Kenneth Scott, Jr. Title:�:�::l Date Reviewed 4/10/2018 VA 22655 tc•.goc , R rm AP002 m x erIC � REQUEST FOR SITE PLAN COMMENTS Fred �8 P ions r 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 Street, 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: A e C4-mF+ o'F Fa. Cl� ✓�� k Telephone: 5'S'o - Yb -1 Email Address: fcxg. rTc & t,,_,2:Ai-v qL • or-, Mailing Address: (o v vb ) C t� �,.rc o,A S ±g✓4 �,,e C_ UX 2A& Name of development and description of the request: Location of Property: Department Comments: -FREDERICK COUNTY INSPECTIONS DEPARTMENT USE ONLY - Date Received 0) N F Review Numbe<D2 3 4 5 (circle one) Date Reviewed `�) 1 p )1 Fr Revision Required ate Approved Signature & Date: 1 I tK �u_4� D Sr► 1� � 1� ** Please Return Form to Applicant** 18 • 0 Buildings shall comply with The Virginia Uniform Statewide Building Code 2012 and section 303 - A,Assembly Use Group. Other Code that applies is ICC/ANSI Al 17.1-09 Accessible and Usable Buildings and Facilities, Virginia Energy Code 2012, Virginia Mechanical Code 2012 and Virginia Plumbing Code 2012. Building plans, including all structural plans, submitted for permit application shall be sealed by a Virginia Licensed Design Professional. Proposed expansion of an existing A -Assembly Use Group. Building shall comply with height and area requirements as allowed for type of construction in T503, IBC 2012. Future addition and pavilion exceed allowable area under Chap 9 without a sprinkler system. Fire barriers can be utilized to reduce the fire area. Question on the existing Type of Construction as defined in Chapter Six with allowable height and area in T503 with proposed addition and wood framed pavilion. Both the roposed new sanctuary and the proposed new gymnasium area less than 12000 sq ft. Occupant load in excess of 300 people require an NFPA 13 approved sprinkler system. Question on sprinkler requirements. Main entrances into areas larger than 3000 sq ft require a vestibule per USBC/International Energy Code. All required exits shall be accessible. Handicap parking shall comply with ANSI A117.1-09. Van accessible parking/unloading shall have a minimum of I V width with 5' unloading area or a minimum of 8' unloading area with an 8' width. Car unloading area shall provide a minimum of 5' unloading area. Max slope of parking and unloading area is 1:48 IBC 1106.6 requires HC parking to be located on the shortest accessible route of travel from adjacent parking to the accessible building entrance. Approaches and door clearances for main exit/entrance shall comply with ANSI Al17.1-09. Landings shall not exceed 1":48" slope. Walkways shall not exceed 5% (1" in 20") slope. Accessible transition from parking and accessible route shall comply with ANSI A 117.1-09. Curb ramps shall comply with Section 406 ANSI A117.1-09. ANSI Al 17.1-09 ramps shall not exceed 1:12 slope. Ramp landings and change of direction shall comply with VUSBC Section 1010.7. Handrails shall be provided and shall comply with VUSBC Section 1010.9 Please note the requirements in Chapter 17 of ICC for special inspection requirements on the type of structure.( Soils, concrete ect..). Slabs with greater than 24" gravel or 8" earth requires an engineer design. S:\Site Plan comments\2012\Assembly, Camp of faith church.doc Buildings, shall comply with The Virginia Uniform Statewide Building Code 2012 and section 303 A,Assembly Use Group. Other Code that applies is ICC/ANSI Al 17.1-09 Accessible and Usable Buildings and Facilities, Virginia Energy Code 2012, Virginia Mechanical Code 2012 and Virginia Plumbing Code 2012. Building plans, including all structural plans, submitted for permit application shall be sealed by a Virginia Licensed Design Professional. Proposed expansion of an existing A -Assembly Use Group. Building shall comply with height and area requirements as allowed for type of construction in T503, IBC 2012. Future addition and pavilion exceed allowable area under Chap 9 without a sprinkler system. Fire barriers can be utilized to reduce the fire area. Question on the existing Type of Construction as defined in Chapter, Six with allowable height and area in T503 with proposed addition and wood framed pavilion. Both the roposed new sanctuary and the proposed new gymnasium area less than 12000 sq ft. Occupant load in excess of 300 people require an NFPA 13 approved sprinkler system. Question on sprinkler requirements. Main entrances into areas larger than 3000 sq ft require a vestibule per USBC/International Energy Code. All required exits shall be accessible. Handicap parking shall comply with ANSI Al 17.1-09. Van accessible parking/unloading shall have a minimum of 11' width with 5' unloading area or a minimum of 8' unloading area with an 8' width. Car unloading area shall provide a minimum of 5' unloading area. Max slope of parking and unloading area is 1:48 IBC 1106.6 requires HC parking to be located on the shortest accessible route of travel from adjacent parking to the accessible building entrance. Approaches and door clearances for main exit/entrance shall comply with ANSI Al 17.1-09. Landings shall not exceed 1":48" slope. Walkways shall not exceed 5% (1" in 20") slope. Accessible transition from parking and accessible route shall comply with ANSI Al 17.1-09. Curb ramps shall comply with Section 406 ANSI A117.1-09. ANSI A117.1-09 ramps shall not exceed 1:12 slope. Ramp landings and change of direction shall comply with VUSBC Section 1010.7. Handrails shall be provided and shall comply with VUSBC Section 1010.9 Please note the requirements in Chapter 17 of ICC for special inspection requirements on the type of structure.( Soils, concrete ect..). Slabs with greater than 24" gravel or 8" earth requires an engineer design. SASite Plan comments\20121Assembly, Camp of faith church.doc i i Kathy Smith From: Internet Mail Delivery <postmaster@ms24522.mac.com> To: molden.fredcogovpc@icloud.com Sent: Thursday, May 17, 2018 9:52 AM Subject: Delivered: Approval Letter for Minor Site Plan #12-18 This report relates to a message you sent with the following header fields: Message-id: <BLOPRO901MB237179C24DF7F9F4E2F382FFA1910@BLOPRO901 MB2371.namprdO9.prod. outlook. com> Date: Thu, 17 May 2018 13:51:47 +0000 From: Kathy Smith <kasmith@fcva.us> To: "molden.fredcogovpc@icloud.com" <molden. fredcogovpc@icloud.com> Subject: Approval Letter for Minor Site Plan #12-18 Your message has been successfully delivered to the following recipients: Recipient address: molden,fredcogovpc@icloud.com Reason: Message successfully delivered Kathy Smith From: Internet Mail Delivery <postmaster@ms18S33.mac.com> To: rthomas.fredcogovpc@icloud.com Sent: Thursday, May 17, 2018 9:48 AM Subject: Delivered: Approval Letter Minor Site Plan #12-18 This report relates to a message you sent with the following header fields: Message -id: <BLOPRO901 MB2371388AOI8BF04CO5C7BE48A1910@BLOPRO901 MB2371.namprdO9.prod.outlook.com> Date: Thu, 17 May 2018 13:48:12 +0000 From: Kathy Smith <kasmith@fcva.us> To: "rthomas.fredcogovpc@icloud.com" <rthomas.fredcogovpc@icloud.com> Subject: Approval Letter Minor Site Plan #12-18 Your message has been successfully delivered to the following recipients: Recipient address: rthomas.fredcogovpc@icloud.com Reason: Message successfully delivered E • Kathy Smith From: Microsoft Outlook To: Robert Wells Sent: Thursday, May 17, 2018 9:45 AM Subject: Delivered: Approval for Minor Site Plan #12-18 Your message has been delivered to the following recipients: Robert Wells (rwells@fcva.usj Subject: Approval for Minor Site Plan #12-18 t COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 April 4, 2018 Jerry Herbaugh The Camp at Faith Hill 635 Double Church Road Stephens City, VA 22655 Re: Review Comments for Site Plan #12-18, The Camp at Faith Hill - Shelter Property Identification Number (PIN): 86-A-72 Dear Mr. Herbuagh: 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 Staff s 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 reference number, SP# 12-18, to the Cover Sheet. 2) Signed Seal. A signed seal of the certified Virginia land surveyor, architect, or engineer who prepared the site plan is required on final copies for signature by the Zoning Administrator. 3) Proiect Title. Add a project title to the Cover Sheet: "The Camp at Faith Hill — 1,600 SF Shelter." 4) Proiect Information. Add the following information and shown below to Sheet 1: • Parcel PIN: 86-A-72 • Magisterial District: Opequon • Zoning: RA (Rural Areas) • Present Use: Church • Proposed Use: Church/Picnic Shelter • Total Site Area: 13.3-acres • Disturbed Area: +/-1.0-acres • Site Setbacks: Front — 60'; Provided — specify,front setback provided Side/Rear — 15'; Provided — specify sidehrear setback provided • Signage: No new site signage proposed. • Lighting: All site lighting shall be downcast and full cutoff. 107 North Kent Street, Suite 202 9 Winchester, Virginia 22601-5000 r 0 0 Re: SP #12-18, The Camp at Faith Hill —Shelter April 4, 2018 Page 2 • Landscaping: No modifications to existing landscaping and screening. • Previous Site Plan Approvals: SP #10-99, #18-01, and #39-01 A2ency Approvals. Comment sheets (approvals) are required from the following agencies: the Inspections Departn7ent, Frederick Water, and the Fire Marshal. After you have revised the site plan, please resubmit one (1) hard copy so that Staff may verify the information contained on the plan addresses the above conmlents. 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, or if you would like to schedule a meeting to discuss. Thank you for your consideration. Sincerely, M. Tyler Klein, AICP Planner MTK/pd cc: The Camp at Faith Hill, 635 Double Church Road, Stephens City, VA 22655 0 COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 April 4, 2018 Jerry Herbaugh The Camp at+z �- l 635 Double Church Road Stephens City, VA 22655 Re: Review Comments for Site Plan #12-18, The Camp at Faith Hill - Shelter Property Identification Number (PIN): 86-A-72 Dear Mr. Herbuagh: 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 Staff s 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 reference number, SP# 12-18, to the Cover Sheet. 2) Signed Seal. A signed seal of the certified Virginia land surveyor, architect, or engineer who prepared the site plan is required on final copies for signature by the Zoning Administrator. 3) Proiect Title. Add a project title to the Cover Sheet: "Th&-Ca FxittrH- i'— 1,600 SF Shelter." 4) Project Information. Add the following information and shown below to Sheet 1: • Parcel PIN: 86-A-72 • Magisterial District: Opequon • Zoning: RA (Rural Areas) • Present Use: Church • Proposed Use: Church/Picnic Shelter • Total Site Area: 13.3-acres • Disturbed Area: +/-1.0-acres • Site Setbacks: Front — 60'; Provided — specify front setback provided Side/Rear — 15'; Provided — specify side/rear setback provided • Signage: No new site signage proposed. • Lighting: All site lighting shall be downcast and full cutoff. 107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000 P' Re: SP #12-18, The Camp at Faith Hill —Shelter April 4, 2018 Page 2 • Landscaping: No modifications to existing landscaping and screening. • Previous Site Plan Approvals: SP #10-99, #18-01, and #39-01 Auney Approvals. Comment sheets (approvals) are. required fiom the following agencies: the Inspections Department, Frederick Water, and the Fine Marshal. After you have revised the site plan, please resubmit one (1) hard 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, or if you would like to schedule a meeting to discuss. Thank you for your consideration. Sincerely, M. Tyler Klein, AICP Planner MTK/pd cc: The Camp atj!EW�, 35 Double Church Road, Stephens City, VA 22655 0 Pam Deeter From: Tyler Klein Sent: Wednesday, May 16, 2018 4:33 PM To: Pam Deeter Subject: Approval Ltr - SP# 12-18 Camp at Faith Church - Pavillion Addition Attachments: Approval Ltr - SP# 12-18 Camp at Faith Church - Pavillion Addition.docx Please find attached the approval letter for the above MDP. I have placed the project file and signed plans in your office. Should you need any additional information, please let me know. Thanks! M. Tyler Klein, AICP Planner Department of Planning & Development Frederick County, Virginia 107 N. Kent Street Winchester, VA 22601 (540)722-8248 tkleinofcva.us 0 • Tyler Klein From: Tyler Klein Sent: Monday, April 30, 2018 9:36 AM To: jaherbaugh@hotmail.com' Subject: Camp of Faith Church - additional plan revision Jerry, good morning. Thank you for taking my call this morning. In order to allow for the Zoning Administrator to approve your plans, we need them to be signed by a certified Virginia land surveyor, architect, or engineer. Final plans must be signed/sealed. Additionally, please remove the following from the plans: "Re: SP #12-18, Camp at Faith Church — Shelter" "April 4, 2018" "Page 2" "Agency Approvals. Comment sheets (approvals) are required...." These elements are not required as part of the "Project Information." Once the above comments are addressed, the plans are signed/sealed and you have received comments from the Department of Building Inspections, please submit a copy of their comment letter and five (5) hard copies of the plans to our office for signature. Should you have any questions, please do not hesitate to get in touch. M. Tyler Klein, AICP Planner Department of Planning & Development Frederick County, Virginia 107 N. Kent Street Winchester, VA 22601 (540)722-8248 tklein fcva.us 0 0 Pam Deeter To: jaherbaugh@hotmail.com Subject: Review comments #12-18 Camp at Faith Hill -Shelter Attachments: Review Comments - #12-18 Camp at Faith Hill - Shelter.docx Good afternoon, Please find attached a letter from Mr. Klein with the review comments for the Camp at Faith Hill -Shelter. If you have any questions, please contact Mr. Klein. Pam Deeter Planning and Development 107 N. Kent Street, Suite 202 Winchester, VA 22601 (540) 665-5651 Pam Deeter From: postmaster@outlook.com To: jaherbaugh@hotmail.com Sent: Wednesday, April 04, 2018 11:31 AM Subject: Delivered: Review comments #12-18 Camp at Faith Hill -Shelter Your message has been delivered to the following recipients: jaherbaugh@hotmail.com (jaherbaugh(a)hotmail.com) Subject: Review comments #12-18 Camp at Faith Hill -Shelter 0 • SITE PLAN APPLICATION - Office Use Only- _ p Date Application Received: / 8 Application #: 2 P Fees Received: -�L� C' Receipt #: 5 i l Initials: Project Title: S� ��r2�►� 2. Project Description: S ti k y6/ , cl5�y 6 -3() �( y 3. Location of Property: Ck o 4 p"ezj Iy 81, r /11, (Street address) 4. Applicant/Designer: Name: A � l� n,0 Of 64Telephone: 57�/O — 9 2 Primary Point of Contact: .46 -, bctsza email: �� Ll�� ®�-}�� w►ci.L < Caw, Address: 6 3 S b y L)6 ( t, C kof-c 1n & Property Owner (if different than above): Name: Address: 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: Proposed Use: Magisterial District(s) Telephone: Ya +o ► o, �J aC b. bk�l� • 7. Site Plan Type: a. Is this an original or new site plan? Yes No b. Is this a revised site plan? Yes5 No If yes provide all previous site plan numbers: c. Is this a minor site plan? Yes No If yes provide all previous site plan numbers: 8. Zoning Information: a. Current Zoning: b. Was this property Rezoned? Yes No c. If yes provide the rezoning number for this property: d. Are there any proffers for this property? Yes No e. Has a MDP been approved for this property? YesH No f. If yes provide the MDP number for this property: 9. Adjoining property zoning and use: USE North East South West 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: Ja"'�� Name (Printed): UC .r, �j Date: 3 "Y`'cq�� —/ 9' V 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). (1) One (1) set of approved cominent sheets are required from each relevant review agency prior to final approval of a site plan. It is recommended that applicants contact the Department of Planning & Development to determine which review agencies are relevant to their site plan application. A list of otentially relevant review agencies is shown below: Frederick County Department of Planning & Development nVirginia Department of Transportation (VDOT) IlDepartment of GIS (Geographic Information Services) Frederick Water Frederick County Building Inspections Department Frederick County Department of Public Works Frederick County Fire Marshal IlVirginia Department of Health nFrederick County Department of Parks & Recreation nCity of Winchester nTown of Stephens City Town of Middletown Winchester Regional Airport Authority Frederick County Public Schools (for residential plans) (2) One (1) copy of the Site Plan application form. F-I_ (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 E �J 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: -TV% r— C'a-✓v t0 D-� On —telephone: 5, b 15� f % Email Address: Pb, sTb r"I'r&y L-rr-Q t L . o Cnv Mailing Address: (�, 3 5 L�C"; Cin. (,r,_k I2� S Qhe�s. C�.4-�! i)a 2aL SS - Name of development and description of the request: au t is k-A-1 a. CSh e. � Location of Property: nn ` 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