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Home My WebLink About14-18 Independent School Of Winc Private School - PIN 52-9-A & 52-9-B - Back Creek - 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: ' ... t File Opened aC� Reference Manual updated/number assigned D-base updated Scan documents to Planning S: drive Application Action Summary updated Scan additional items as needed (Project Planner to direct) CLOSE FILE: (Q I Approved (or denied) letter mailed to applicant/copy to file and cc's (d File stamped "approved", "denied" or "withdrawn" Reference Manual updated �p lv Y D-base updated l� Scanning updated Application Action Summary updated Sys ID # DATE 9 ' V RECEIVED FROM /! ADDRESS FOR ECEIPT 721,936 _" NL/ I V . i 1nJ h i ice. 1 ACCOUNT HOW PAID BEGINNING CASH BALANCE AMOUNT CHECK i PAID BALANCE MONEY DUE ORDER Tyler Klein From: Tyler Klein Sent: Friday, August 17, 2018 1:12 PM To: 'Tom Thorpe' Cc: John J Subject: RE: Completed punch list for 769 round hill rd Tom (& John) with the removal of the dumpster, shielding of the lights, and removal of the temporary sign everything looks complete on our end, and in conformance with the approved site plan. I will go ahead and notify Building Inspections our portion is complete and they may issue final Certificate of Occupancy (pending completion of all other inspections. If you need anything else, please let us know. M. Tyler Klein, AICP Senior Planner Department of Planning & Development Frederick County, Virginia 107 N. Kent Street Winchester, VA 22601 (540)722-8248 tklein(c�fcva.us From: Tom Thorpe <tthorpe@encoredbc.com> Sent: Friday, August 17, 2018 12:39 PM To: Tyler Klein <tklein@fcva.us> Cc: John J <jjohnson@encoredbc.com> Subject: Completed punch list for 769 round hill rd Thanks Tyler have a great weekend! FREDERICK COUNTY DEPARTMENT OF PLANNING & DEVELOPMENT Site Inspection Form e3s�a�� i�t�'i�fATION Permit Holder Name Property Identification Number (PIN) Site Plan or Subdivision Plan Number Location Building Permit Number Contact Information INSPECTION OR ROADS, DRIVEWAYS E TRAVEL AISLES (Check when completed - note all incomplete work): Nr�_ Street & Traffic Signs Sidewalks & Lighting � Striping Dimensions Surface Material Overall Layout Comments Inspector Date Verified Incomplete Inspector , Date Verified Complete INSPECTION OF PARFING, MANEUVERING AREAS & LOADING AREAS (Check when completed - note all incomplete work): Number of Spaces Striping Surface Material Comment Inspector Inspector Sidewalks & Lighting Dimension of Spaces Overall Layout-Sb�/-- Date Verified Incomplete Date Verified Complete INSPECTION OF LANDSCAPING IMPROVEMENTS ((CCheck when completed - note all incomplete work): Q Number of Trees � Number of Shrubs A Species of Plants Size of Plants Seeding Soil Stabilization Overall Layout Screens Comments Date Verified Incomplete Inspector — / Date Verified Complete Inspector INSPECTION OF OTtMR IMPROVEMENTS (Check when completed - note all incomplete work): Recreational Facilities Setbacks Proffered Conditions Preservation Areas Curb & Gutter Signs -Z o Comments N�7Iv S'� Inspector Date Verified Incomplete - Date Verified Complete Inspector r Signature _ Date of Approval Is site approval contingent on a monetary guarantee? Yes* No Bond Number (*If yes, all site improvements noted on this form mtist: be complete prior to the release of a monetary guarantee. In addition, all relevant review agencies shall provide final site approval. A checklist of these agencies is provided below for documentation purposes.; Fire Marshal Virginia Department of Transportation Building Inspections Sanitation Authority -- Public Works City of. Winchester -- - Parks & Recreation other (please date & initial when all site work is complete & all relevant review agencies have approved) Initials Date monetary Guarantee Released COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 June 6, 2018 John C. Lewis Painter -Lewis, PLC 817 Cedar Creek Grade, Suite 120 Winchester, VA 22601 Re: Approval for Minor Site Plan #14-18, Independent School of Winchester Property Identification Number (PIN): 52-9-A & 52-9-B Dear Mr. Lewis: The above -referenced minor site plan was approved on June 6, 2018. The minor site plan is approved for conversion of the 10,508 square foot (SF) old Round Hill Volunteer Fire Station into a private school (serving 50 to 75 students) with 19 parking spaces in the RA (Rural Areas) Zoning District in the Back Creek 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 four (4) 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: Gary A. Lofton, Back Creek District Supervisor J. Rhodes Marston and Greg L. Unger, Back Creek District Planning Commissioner Jane Anderson, Real Estate Commissioner of Revenue Independent School of Winchester, Inc., 3 Battaile Drive, Winchester, VA, 22601 107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000 Pam Deeter To: Gary Lofton; Greg Unger; Rhodes Marston Subject: site plan approval Attachments: Approval Ltr - SP#14-18 Independent School of Winchester.docx Good morning, Please find attached a site plan approval letter from Mr. Klein for Independent School of Winchester which is in your magisterial district. 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 0 • Pam Deeter From: Microsoft Outlook To: Rhodes Marston Sent: Wednesday, June 06, 2018 10:03 AM Subject: Relayed: site plan approval Delivery to these recipients or groups is complete, but no delivery notification was sent by the destination server: Rhodes Marston (jrmmarston(@gmail.com) Subject: site plan approval Pam Deeter From: Microsoft Outlook To: Gary Lofton Sent: Wednesday, June 06, 2018 10:03 AM Subject: Delivered: site plan approval Your message has been delivered to the following recipients: Gary Lofton (glofton@fcva.us) Subject: site plan approval 0 Pam Deeter From: Microsoft Outlook To: Greg Unger Sent: Wednesday, June 06, 2018 10:03 AM Subject: Relayed: site plan approval Delivery to these recipients or groups is complete, but no delivery notification was sent by the destination server: Greg Unger (greglunger@yahoo.com) Subject: site plan approval LJ PAINTER-LEWIS, P.L.C. CONSUL TING ENGINEERS 817 Cedar Creek Grade, Suite 120 Winchester, VA 22601 30 May 2018 Mr. Tyler Klein Frederick County Department of Planning and Zoning 107 North Kent Street Winchester, VA 22601 RE: SP #14-18 Independent School of Winchester Dear Tyler: tel.: (540)662-5792 fax.: (540)662-5793 email: office@painterlewis.com Your comments contained in correspondence dated May 30, 2018 have been ad- dressed as follows: • The existing dumpster pad will not be used. Trash will be accumulated in the build- ing and taken to the landfill by staff. This information is reflected on Sheet 1. • The installation of curbing is impractical due to the absence of storm sewer facili- ties and lack of fall across the site. Sheet flow across the parking areas will result in less adverse impact than flow concentration by curbing. Application of tar & chop surface to the existing gravel parking areas will result in minimal disturb- ance of the existing conditions. The school hereby requests that the requirement for curbing and bituminous/concrete pavement be waived. • The pickup/drop off area is noted on the Sheet 4. • There will be 8 high school students requiring 1 parking space. This information is reflected on Sheet 1. Along with this letter you will find a copy of the revised site plan. VERY TRULY YOURS; John C. Lewis, P.E., C.L.A. Job No.: 1705020 Page - 1 Tyler Klein From: Tyler Klein Sent: Monday, June 04, 2018 9:45 AM To: 'John Lewis' Cc: Joseph Johnson; Mark Cheran Subject: RE: Independent School of Winchester Hi John, I have confirmed with our County Engineer, the tar and chip and elimination of the curb and gutter at the ISW site is acceptable. I also need the "attached" comments referenced in the VDOT cover memo. All other site plan comments have been addressed and the plan is approvable. Please provide the hard copies for signature by the Zoning Administrator along, the VDOT comment letter attachment, and a PDF copy of the plans for our records. Should you have any questions, please get in touch with me directly. Best, Tyler From: John Lewis <jclewis@painterlewis.com> Sent: Saturday, June 02, 2018 8:14 AM To: Tyler Klein <tklein@fcva.us> Subject: Independent School of Winchester Please see attachment. The school year is fast approaching and they cannot begin construction without site plan approval....what is left on your end? John C. Lewis Painter -Lewis, P.L.C. 817 Cedar Creek Grade, Suite 120 Winchester, VA 22601 Tel: 540-662-5792 Fax: 540-662-5793 email: Iclewis(cDpainterlewis.com PAINTER-LEWIS, P.L.C. CONSUL TINGENGINEERS tel.: (540)662-5792 817 Cedar Creek Grade, Suite 120 fax.: (540)662-5793 Winchester, VA 22601 email: office@painterlewis.com 26 May 2018 Mr. Tyler Klein Frederick County Department of Planning and Development 107 North Kent Street Winchester, VA 22601 RE: Independent School of Winchester Site Plan #14-18 Dear Tyler: Your comments contained in correspondence dated April 30, 2018 have been ad- dressed as follows: 1.The plan number has been added to Sheet 1. 2.The reference to Virginia Department of Health has been added on Sheet 1. 3. The existing use has been updated to "vacant". The setbacks have been revised. The sign notes have been added and the sign location is shown on the north side of the tracks. The previous site plan number has been added. 4.Agency comments are forthcoming. Along with this letter you will find one copy of the revised site plan. VERY TRULY YOURS; John C. Lewis, P.E., C.L.A. Job No: 1705020 Page - 1 0 April 30, 2018 John C. Lewis Painter -Lewis, PLC 817 Cedar Creek Grade, Suite 120 Winchester, VA 22601 0 COUNTY of FREDERICK Department of Planning and Development 540/ 665-5651 Fax: 540/ 665-6395 Re: Review Comments for Minor Site Plan #14-18, Independent School of Winchester Property Identification Number (PIN): 52-9-A & 52-9-B Dear Mr. Lewis: 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 cannot be approved 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 number, SP 914-18, to the plan set cover. 2) Utility Contacts. Update FCSA to "Frederick Water." 3) Development Notes. The following revisions should be made to Sheet 1: • Update "Existing Use" to include "Vacant;" • Update the side and rear setback to be 100-feet (FT), as required when the adjacent properties are greater than 6-acres (Parcel PIN #s 52-A-261 and 52-A-261 A). • Further specify the proposed sign type is a freestanding monument sign, not to exceed 1 OFT in height and 50 square feet (SF) in sign area. Indicate the proposed sign location on Sheet 4. • Specify "Previous Approvals" including Site Plan (SP) #23-79. 4) Agency Approvals. Comment sheets (approvals) are required from the following agencies: Building Inspections, the County Engineer (Public Works), the Fire Marshall, the Virginia Department of Transportation (VDOT), the Virginia 107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000 0 0 Review Comments — SP #14-18, Independent School of Winchester April 30, 2018 Page 2 Department of Health, and Frederick Water. 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 set and a digital (PDF) copy for approval. Do not hesitate to contact me if you have any questions or concerns regarding this letter. Sincerely, M. Tyler Klein, AICP Planner MTK/pd Attachment cc: Independent School of Winchester, Inc., 3 Battaile Drive, Winchester, VA, 22601 0 lid 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 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: Painter -Lewis, P.L.C. Telephone: 540-662-5792 Email Address: office@painterlewis.com Mailing Address: 817 Cedar Creek Grade "'`'•..,,,�_ Suite #120 Winchester, Virginia 22601 Name of development and description of the request: Independent School of Winchester -at the former Round Hill Fire Hall Location of Property: 769 Round Hill Road, Winchester, Virginia, 22602 Department Co -FREDERICK COUNTY INSPECTIONS DEPARTMENT USE ONLY - Date Received ,' 3 1 Review Number 1 2 3 4 5 (circle one) Date Reviewed / --7 Revision Required . �jDate Approve :3 Signature & Date: / ** Please Return Form to Applicant** 18 0 • Buildings shall comply with The 2012 Virginia Uniform Statewide Building Code and Section 305 — E-Educational Use Group and 2012 Virginia Existing Building Code. Other Code that applies is ICC/ANSI Al 17.1-09 Accessible and Usable Buildings and Facilities, 2012 Virginia Energy Code, 2012 Virginia Mechanical Code, 2012 Virginia Plumbing Code, and 2012 Virginia Fire Code. Structural plans and plans submitted for permits for the alterations and remodeling of interior spaces shall be sealed by a Virginia Licensed Design Professional. Change of use of an existing Fire Hall to E-Educational. Building height and area shall comply with T503 with allowable increases A change of use permit is required for existing building. Please submit a detailed floor plan with your permit An accessible route shall be provided to the main entrance. Van accessible parking and unloading provided. Max slope for parking and unloading area is 2%. Maximum slope for walkway to main entrance is 5%. Maximum threshold at door is'/4". Installation of accessible parking and unloading and walkway to main entrance shall comply with ANSI A117.1-2009 Restroom quantities shall be provided as required for occupant load under T2901 and the Virginia Existing Building Code 2012 Carbon Monoxide detectors shall be installed as required per Section 908.7.2 Van accessible signage shall be provided per USBC Section 1106.8 20% ANSI A117.01-09 rule applies. Asbestos inspection is required. Asbestos abatement permit may be required for any interior renovations. S:\Site Plan comments\2012\E-Educational change of use School.docx 0 0 Buildings shall comply with The 2012 Virginia Uniform Statewide Building Code and Section 305 — E-Educational Use Group and 2012 Virginia Existing Building Code. Other Code that applies is ICC/ANSI A117.1-09 Accessible and Usable Buildings and Facilities, 2012 Virginia Energy Code, 2012 Virginia Mechanical Code, 2012 Virginia Plumbing Code, and 2012 Virginia Fire Code. Structural plans and plans submitted for permits for the alterations and remodeling of interior spaces shall be sealed by a Virginia Licensed Design Professional. Change of use of an existing Fire Hall to E-Educational. Building height and area shall comply with T503 with allowable increases A change of use permit is required for existing building. Please submit a detailed floor plan with your permit An accessible route shall be provided to the main entrance. Van accessible parking and unloading provided. Max slope for parking and unloading area is 2%. Maximum slope for walkway to main entrance is 5%. Maximum threshold at door is 3/a". Installation of accessible parking and unloading and walkway to main entrance shall comply with ANSI A117.1-2009 Restroom quantities shall be provided as required for occupant load under T2901 and the Virginia Existing Building Code 2012 Carbon Monoxide detectors shall be installed as required per Section 908.7.2 Van accessible signage shall be provided per USBC Section 1106.8 20% ANSI A117.01-09 rule applies. Asbestos inspection is required. Asbestos abatement permit may be required for any interior renovations. S:\Site Plan conunents\2012\E-Educational change of use School.docx 0 John Lewis From: Painter -Lewis, PLC - Office <office@painterlewis.com> Sent: Tuesday, April 24, 2018 3:09 PM To: John Lewis Subject: FW: Independent School of Winchester - VDOT Site Plan Comments Attachments: Scanned from EDNXerox.pdf From: Rhonda Funkhouser <Rhonda.Fun khouser@vdot.virginia.gov> Sent: Tuesday, April 24, 2018 2:51 PM To: office@ painterlewis.com;jclewis@painterlewis.com Cc: jbishop@fcva.us; Lloyd Ingram <Iloyd.ingram@vdot.virginia.gov>; Matthew Smith <matthew.smith@vdot.virginia.gov> Subject: Independent School of Winchester - VDOT Site Plan Comments Mr. Lewis, VDOT conducted a review of the Independent School of Winchester site plan with a seal date of March 23, 2018. Based on the review of the drawings, the existing entrance from Route 769 is adequate for the proposed site plan. Should the business ever expand in the future, existing entrances may need to be upgraded. Please ensure all applicable agencies have the most recent set of approved drawings. We offer the following general comments: • Our review and comments are general in nature. Should details have been overlooked during plan review or conditions in the field exist such that additional measures are warranted, such measures will be completed to the satisfaction of the department. • Materials used and methods of construction shall adhere to the current observed VDOT Road and Bridge Specifications, Road and Bridge Standards, Manual on Uniform Traffic Control Devices , and Land Use Permit Special Provisions. • All drainage will be carried within the right-of-way in ditch lines or gutters along the street to a pipe or drainage easement. • Any construction related changes to the approved plan must come through the design engineer to VDOT for approval. Please allow a minimum of five business days for VDOT review. • A Land Use Permit shall be obtained before any work is performed on the State's right-of-way. The permit issued by this office and may require application fees, the salary & expenses of a State assigned inspector, and surety bond coverage. If you have any questions or need further information, please do not hesitate to contact me. Sincerely, 1 F-7 LJ • Lloyd A. Ingram I Land Development Engineer Virginia Department of Transportation Clarke, Frederick, Shenandoah & Warren Counties 14031 Old Valley Pike Edinburg, VA 22824 voice: 540/984-5611 fax: 540/984-5607 e-mail: Lloyd.Ingram@vdot.virqinia.gov 0 9 Frederick Coun(y Department of Fire and Rescue Office of the Fire Marshal 1080 Co erstone nriw 14'lnrhester, EA 22602 (.540) 665-6350 Fax., (540) 678-4739 Email: fnogh-va.us Plan Review & Comments Date Received 312 312018 Plan.rPermit Type Site Plan 03-23-18 Name Independent School of Winchester Address 769 Round Hill RD Winchester Project Name New Tenant Applicant Name & Number Painter -Lewis, PLC 540-662-5792 RE0 Permit Number Emergency Vehicle Access! Adequee Inadequate N/A Hydrant Location: Adequate Inadequate WA Siamese Location: Adequate Inadequate N Fire lanes Required: No N/A Plan Approval Status Approve Comments Areas hl-Iighted In yellow shall be stripped in yellow Areas hi -lighted in orange shall have No Parking Fire Lane signs installed Signature: Reviewed By. Kenneth Scott, Jr. 1� Title:��.r Date Reviewed 3/30/2018 VA 22602 0 0 I lose-le-0 REQUEST FOR SITE PLAN COMMENTS Virginia Department of Transportation Mail to:, Virginia Department of Transportation Attn: Resident Engineer 14031 Old Valley Pike Edinburg, Virginia 22824 Phone: (540) 984-5600 Hand deliver to: Virginia Department of Transportation Attn: Resident Engineer 2275 Northwestern Pike Winchester, Virginia 22603 Applicant: Please fill out the information as accurately as possible in order to assist the Virginia Department of Transportation with their review. Please attach two (2) copies of the site plan with traffic generation data and drainage calculations with this sheet. Applicant's Name: Painter -Lewis. P.L.C. Email Address: once®paintedewiscom Mailing Address: 917 cedar creek Grade Suite #120 Winchester, Virginia 22601 Name of development and description of the request: Independent School of Winchester -at the former Round MI Fire Hal Location of Property: 769 Round Hill Road, Winchester, Virginia. 22602 Date Received Telephone: 540-662-5792 -VDOT USE ON LY- Review Number 1 2 3 4 5 (circle one) Date Reviewed Revision Required Date Approved VDOT Signature & Date: . Please Return Form to Applicant" 15 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 Engintxr 107 North Kent Street, 2"d F loor 107 ?north Kent Street Winchester, Virgi(ria 22601 Winchester, Virginia 22601 Phone: (540) 605-5643 Applicant: It i:, dour rvsponsibiliry to mniplete this form as accurately as possible in order to amist the agency with their flleio mach nre i, i_i c« pics of the Sitc Plan w Applicant's Name: Paint,-LevAs,Pt_c. 'Telephone: 540-662-5722 Email Address: o @Pafntf3lt wt8.G'w Mailing Address: 017Ceder Greek Uladu $ #120 Wlrndiestrx, VOWAs 22WI Name of development and description of the request: incoptrdent ;drool of Winchester -at tFw tormar Ruutwi Mil Fire KO Lmation of Property: 769 Round KI Rmi. Windiostot, Virginia, 27OW Public Works Department Comments: -FREDERWX COUNTY PUBLIC WORKS DEPARTMENT USE ONLY - Date Received Rcview Number 1 2 3 4 S (circle one) t aic Rev 4: v« cj _ Revision Required DMA�roved „ Si�namre Date. ., 19 2. SITE PLAN APPLICATION - Office Use Only- p Date Application Received: Application #: O� I� Fees Received: R tr &() Receipt #: -1 a t 5 3 (PInitials: 1 Project Title: Independent School of Winchester Project Description: Conversion of the former Round Hill Fire Hall to a private school 3. Location of Property: 769 Round Hill Road (Street address) 4. Applicant/Designer: Name: Painter -Lewis, P.L.C. Telephone: 540-662-5972 Primary Point of Contact: John Lewis email: office@painterlewis.com Address: 817 Cedar Creek Grade, Suite #120, Winchester, VA, 22601 5. Property Owner (if different than above): Name: The Independent School of Winchester, Inc. Address: 3 Battaile Drive Winchester, VA 22601 6. 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) 8 Telephone: 540-877-5552 52-9-A, 52-9-B 7.06 0.8 vacant Private School Back Creek 0 • 7. Site Plan Type: a. Is this an original or new site plan? Yes II No b. Is this a revised site plan? Yes No If yes provide all previous site plan numbers: C. Is this a minor site plan? Yes n No If yes provide all previous site plan numbers: 8. Zoning Information: a. Current Zoning: (RA) Rural Area b. Was this property Rezoned? Yes F-1 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? Yes 19 No 14 f. If yes provide the MDP number for this property: 9. Adjoining property zoning and use: USE ZONING North Residential RA -Rural Area East Residential RA -Rural Area South Agricultural RA -Rural Area West Agricultural RA -Rural Area 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: Naive (Printed): John Lewis Date: 3-23-2018 9 Special Limited Power of Attorney 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) (Name) Claire McDonald (Phone) 540-877-5552 (Address) �Battaile-Drive-Winchester, VA-2260t 130 CA-9AEV:5 o U(:; De- STEfVV0,JSL4X-J JA 2Zto s� 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. 180000965 on Page , and is described as Parcel: A & B Lot: Block: Section: Subdivision: do hereby make, constitute and appoint: (Name) Painter -Lewis, P.L.C. (Phone) 540-662-5792 (Address) 817 Cedar Creek Grade, Suite #120, Winchester, Virginia, 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: _Rezoning (including proffers) _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 or modified. In witness thereof, I (we) have hereto set my (our) hand and seal this S day of A9—n , 2015 , Signature(s) ` r'g . �'[�u, YN ' 6V7 ,-«- - State of Virginia, City/County of Winchester/Frederick , To -wit: I, �. ,%�� i1�—�_° btu Public in and for the jurisdiction aforesaid, certify that the person(s) who signed to the y, "r*iI . �nt personally appeared before me and has ac o,*twledged the same before me in the jurisc�� n ies day of � L, 20my . I COMMi �o}rnsion Expires: c�[� otary Public o o = ?. ••. 7532024 •< a0cument ApprQl,,af Fcrzn PLEASE REVIEfV THE ATTACHED DO S E rldIT YOUR APPROVAL, PLEACt771�EJ�T; � THISDOCU1�fE11T l4�IEETS YO UR APPROVAL, A'MD FRO VIDE TIfE DATE AID TrME OF rnifiais Da% & Time Candice %rk have Tyler Mike d 7-0 Received by Clerics! St&ff(Isate & 1,ime 'g:UBice an B/tckborlForm"70cument APProvtl Form-617,2016) 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: Painter -Lewis, P.L.C. Telephone: 540-662-5792 Email Address: otfiice@painteriewis.com Mailing Address: 817 Cedar Creek Grade Suite #120 Winchester, Virginia 22601 Name of development and description of the request: Independent School of Winchester -at the former Round Hill Fire Hall Location of Property: 769 Round Hill Road, Winchester, Virginia, 22602 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: ** Please Return Form to Applicant** E