HomeMy WebLinkAbout26-99 Nanette M McFarland - Back Creek - BackfileCUP TRACKING SHEET
(To be completed by Frederick Co. Staff only.)
CUP # c � G - � q
Owner/Applicant _ Nd,\)LT_TL dLJ AD
Application Date /o- a V` T q
Fee Paid 10 yes initials: �J4
Sign Deposit EZ� yes Sign return date:
Submittal Cut -Off Date o ' 1
P/C Mtg. date: /� - / - BOS Mtg. date: - -o
;j VDOT
Inspections
Fire Marshal
t,- Health Dept.
AGENCY REVIEW COMMENTS
Airport Authority
City of Winchester
I/ Co Sanitation Authority
PLANNING COMMISSION RECOMMENDATIONS OF
(date)
APPROVAL (WITH CONDITIONS) _kLyes no
DENIAL
Sig ne
ecretary
Date
BOARD OF SUPERVISORS PUBLIC HEARING TION ft4hAA Z2HOC
(d te)
APPROVAL r
Signed ,Cou Yaw.
DENIAL Date '
NOTES
Date:
1�-22 99 File opened
Reference Manual updated/number assigned
1/ D-base updated
,/ 40 color location maps requested from GIS
V/ Four sets of labels requested from Data Processing
l / . 99 File given to Renee' to update Application Action Summary
Xk,
CLOSE OUT FILE:
Approval (or denial) letter mailed to applicant/copy made for file
File stamped "approved", "denied" or "withdrawn"
V Reference Manual updated
D-base updated
File given to Renee' for final update to Application Action Summary
U AC azo1\Common\C UP.TRK
Revised Sept. 13, 1999
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ORDER
�e COUNTY of FREDERI CK
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Department of Planning and Development
540/665-5651
FAX: 540/ 673-0632
MEMORANDUM
TO: Finance Department
FROM: Karen A. Cain, Receptionist/Office Assistant II
SUBJECT: Return Of Sign Deposit
DATE: January 18, 2000
The amount of $50.00 was deposited in line item #10-911-08 for the person named below as a
deposit for a sign for Conditional Use Permit Application #26-99. They have now returned the
sign and are therefore entitled to the return of their deposit. You may pay this through the regular
bill cycle.
Please send a check in the amount of $50.00 to:
RSA/kac
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Mr. Larry McFarland
3782 Wardensville Grade
Winchester, Virginia 22602
a
107 North Kent Street - Winchester, Virginia 22601-5000
• • 16LE COPY
COUNTY of FREDERICK
Department of Planning and Development
540/665-5651
FAX: 540/ 678-0682
January 14, 2000
Ms. Nanette M. McFarland
3782 Wardensville Grade
Winchester, VA 22602
RE: CUP #26-99 of Nanette M. McFarland, P.I.N. 59-A-20E
Dear Ms. McFarland:
This letter is to confirm action taken by the Frederick County Board of Supervisors at their meeting of
January 12, 2000.
Your Conditional Use Permit, #26-99 to establish a kennel for a pet -sitting service, was approved with
the following conditions:
1. All agency comments should be complied with at all times.
2. All requirements of the Frederick County Code and the Code of Virginia pertaining to kennels
shall be complied at all times.
3. No more then five (5) animals other than those owned by the applicant shall be boarded at one
time.
4. Any proposed business sign shall conform with the Cottage Occupation requirements (sign shall
not exceed four (4) square feet).
5. Any expansion of this use would require a new Conditional Use Permit.
If you have any questions regarding this action or the site plan application, please feel free to call this
office.
Sincerely,
k R. Cheran
Planner I
MRC/ch
cc: Commissioner of Revenue
O:\Agmdas\APPR_DEN.LTR\CUP's\McFar]and.CUP.wpd
107 North Kent Street - Winchester, Virginia 22601-5000
0 46
PC REVIEW: 12/01/99
BOS REVIEW: 01/12/00
CONDITIONAL USE PERMIT #26-99
NANETTE M. McFARLAND
Kennel
LOCATION: This property is located at 3782 Wardensville Grade.
MAGISTERIAL DISTRICT: Back Creek
PROPERTY ID NUMBER: 59-A-20E
PROPERTY ZONING & PRESENT USE: Zoned RA (Rural Areas) District; Land Use:
Residential
ADJOINING PROPERTY ZONING & USE: Zoned RA (Rural Areas) District; Land Use:
Residential and Vacant
PROPOSED USE: To establish a kennel for a "pet sitting" service
REVIEW EVALUATIONS:
Virginia Dept. of Transportation: No objection to a conditional use permit for this
property. Existing entrance is adequate for proposed use. However, should use ever expand
in the future, the entrance may have to be upgraded to VDOT minimum commercial
standards.
Inspections Department: Area of building shall comply with The Virginia Uniform
Statewide Building Code and the BOCA National Building Code/1996. Please submit a floor
plan of the area for a change of use building permit. Note the requirements in the
International Mechanical Code for the proper air change for kennels within buildings.
Fire Marshal: Emergency vehicle access (width and overhead clearances) must be
maintained to accommodate fire apparatus. Plan approval is recommended.
E
0
Nanette McFarland CUP #26-99
Page 2
January 4, 2000
Health Department: A walkover of the sewage disposal system was conducted on
10/14/99; no problems with the system were evident. As there will be no increased use ofthe
sewage disposal system for the proposed conditional use permit, the Health Department has
no objection to the proposed conditional use permit.
Sanitation. Authority: No comment.
Planning and Zoning: Kennels are a permitted use in the RA (Rural Areas) Zoning District
with an approved conditional use permit. As defined in the Frederick County Zoning
Ordinance, a kennel is a place to house, board, breed, handle or otherwise care for dogs for
sale or in return for compensation. The applicant states that their operation will involve
boarding of approximately five (5) animals in the basement of the dwelling. The property is
currently being used as a home occupation for a pet -sitting service,'in which the applicant pet -
sits at the clients' homes.
The property is surrounded by natural mature woodlands; the nearest property is 150 feet
from the residence in which the applicant is proposing to use for the business. Based upon the
limited scale of the proposed use and a review and evaluation of the property, it appears this
use would not have any significant impacts on the adjoining properties.
STAFF CONCLUSIONS FOR 12-01-99 PLANNING COMMISSION MEETING: Staff
recommends approval of this request with the following conditions:
All agency comments should be complied with at all times.
2. All requirements of the Frederick County Code and the Code of Virginia pertaining to kennels
shall be complied at all times.
3. No more then five (5) animals other than those owned by the applicant shall be boarded at one
time.
4. Any proposed business sign shall conform with the Cottage Occupation requirements (sign
shall not exceed four (4) square feet).
5. Any expansion of this use would require a new Conditional Use Permit.
Nanette McFarland CUP #26-99
Page 3
January 4, 2000
PLANNING COMMISSION SUMMARY & ACTION OF 12/01/99 MEETING: Members of
the Commission inquired of the applicant if she would be able to keep the animals indoors, especially
during the night. The applicant responded that she would be able to accomplish this.
There were no public comments.
Members of the Commission believed that as long as the animals are kept inside of a completely
enclosed structure, the impact on the surrounding neighborhood should be minimal. The Commission
unanimously recommended approval of the kennel with the same conditions recommended by the
staff, as follows:
All agency comments should be complied with at all times.
2. All requirements of the Frederick County Code and the Code of Virginia pertaining to kennels
shall be complied at all times.
3. No more then five (5) animals other than those owned by the applicant shall be boarded at one
time.
4. Any proposed business sign shall conform with the Cottage Occupation requirements (sign
shall not exceed four (4) square feet).
Any expansion of this use would require a new Conditional Use Permit.
(Note: Mr. Stone, Mr. Light, and Mr. Marker were not present for this vote.)
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Produced by Frederick County Planning and Development, 11-16-99
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COUNTY of FREDERICK
Department of Planning and Development
5401665-5651
FAX: 540/ 678-0682
I rIFICIAtICU! I Jr" PUBLIC i-IsrARIl Ir' .
December 29, 1999
TO: THE APPLICANTS) AND/OR ADJOINING PROPERTY OWNER(S)
RE: APPLICATION OF NANETTE M. McFARLAND, CONDITIONAL USE PERMIT #26-99
On behalf of the Frederick County Board of Supervisors, you are hereby notified of a public hearing
being held on January 12, 2000, at 7:15 p.m., in the board room of the Frederick County
Administration Building at 107 N. Kent Street, Winchester, Virginia. This hearing is to consider
Conditional Use Permit #26-99 of Nanette M. McFarland for a kennel (pet -sitting business). The
property is located at 3782 Wardensville Grade and is identified with Property Identification Number
59-A-20E in the Back Creek Magisterial District.
Any interested parties having questions or wishing to speak may attend this meeting. A copy of the
application will be available for review at the Handley Library (temporary Loudoun Street Mall
location) approximately one week prior to the meeting, or at the Department of Planning and
Development located at 107 North Kent Street in Winchester, Virginia.
Sincerely,
��'Z��
Mark R. Che n
Planner I
MRC/ch
O:\Agendas\ADIOIN ER\McFazland.CUP.wpd
107 North Kent Street - Winchester, Virginia 22601-5000
This is to cer that, the attached correspondence was mailed, to the following on
from the Department ofPlanning and Development, Frederick
County, Virginia:
59 - A- - 20-F
SMITH, CARROLL G.
6312 MIDDLE RD
STEPHENS CITY, VA
59 - A- - 20-D
LAMBERT, DENNIS D
PO BOX 3461
WINCHESTER,VA
22655.5132
i
I
22604.1161
59 - A- - 57-A�
BAUSERMAN, EARL D & VIRGINIA L
3737 WARDENSVILLE GRADE
WINCHESTER, VA 22602.3268
A
59 -A- - 21-
j MCNEIL, JERALD T
740 MEADOW CIR
ESTES PARK, CO
I
80517.8409
59 -A- - 20-E - ------
MCFARLAND, LARRY D
& MORGAN, NANETTE M
3782 WARDENSVILLE GRADE
WINCHESTER, VA 22602.3257
Mark R. Cheran, Planner I
Frederick Co. Planning Dept.
STATE OF VIRGINIA
COUNTY OF FREDERICK
I, �i—AD ffir) Oct ' � , a Notary Public in .and for the State and County
aforesaid, do hereby certify that Mark R. Cheran, Planner I, for the Department of Planning and
Development, whose name is signed to the foregoing, dated J i - 1. Ci has
personally. appeared before me and acknowledged the same in my State and County aforesaid.
Given under my hand thisyl�+' 1 day of 'r� �� ��`l �� '� C L/
i
My commission expires onC
Ie f
"NDTkRY PUBLIC
COUNTY of FREDERICK
Department of Planning and Development
5401665-5651
FAX: 540/ 678-0682
107Ir"IrMIO! I OF PUBLIC HEARING.
November 17, 1999
TO: THE APPLICANT(S) AND/OR ADJOINING PROPERTY OWNER(S)
RE: APPLICATION OF NANETTE M. McFARLAND, CONDITIONAL USE PERMIT #26-99
On behalf of the Frederick County Planning Commission, you are hereby notified of a public hearing
being held on December 1, 1999, at 7:00 p.m., in the board room of the Frederick County
Administration Building at 107 N. Kent Street, Winchester, Virginia. This hearing is to consider
Conditional Use Permit #26-99 of Nanette M. McFarland for a kennel (pet -sitting business). The
property is located at 3782 Wardensville Grade and is identified with Property Identification Number
59-A-20E in the Back Creek Magisterial District.
Any interested parties having questions or wishing to speak may attend this meeting. A copy of the
application will be available for review at the Handley Library (temporary Loudoun Street Mall
location) approximately one week prior to the meeting, or at the Department of Planning and
Development located at 107 North Kent Street in Winchester, Virginia.
Sincerely,
Mark R. Cheran
Planner I
MRC/ch
O:\Agendas\ADJOINER\McFarland.CUP.wpd
107 North Kent Street • Winchester, Virginia 22601-5000
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This is to certify that the attached correspondence was mailed to the following on
from the Department ofPlanning and Development, Frederick
County;Virginia:
59 - A- - 20-E�
59 - A- - RR I MCFARLAND, LARRY D
SMITH, CARROLL G.
6312 MIDDLE RD & MORGAN, NANETTE M
STEPHENS CITY, VA. 22655.5132 3782 WARDENSVILLE GRADE
WINCHESTER, VA 22602.3257
59 - A- - 20-D
LAMBERT, DENNIS D
PO BOX 3461
WINCHESTER, VA
22604-1161
59 - A- - 57-A
BAUSERMAN, EARL D & VIRGINIA L
3737 WARDENSVILLE GRADE
WINCHESTER, VA 22602.3268
I
59 -A- - 21-
MCNEIL, JERALD T
740 MEADOW CIR
ESTES PARK, CO
80517.8409
Mark R. Cheran, Planner I
Frederick Co. Planning Dept.
STATE OF VIRGINIA
COUNTY OF FREDERICK
I, Lib ffin I 1 , a Notary Public in and for the State and County
aforesaid, do hereby certify that Mark R. Cheran, Planner I, for tM119-ag
Dertment of Planning and
Development, whose name is signed to the foregoing, dated , has
personally appeared before me and acknowledged the same in my State and County aforesaid.
Given under my hand this Ill h day of npyEmbu-, 1 q q l
My commission expires on ruC1Vl_.i�,
TARP PUBLIC
Submittal Deadline
P/C Meeting
BOS Meeting
APPLICATION FOR CONDITIONAL USE PERMIT
FREDERICK COUNTY, VIRGINIA
1. Applicant (The applicant if the V- owner other)
NAME: _mane k
ADDRESS: 2)1 p�, UaAensocU-e G-1-c�c1e- , WinckeSi-eR. VIA
TELEPHONE C '�rl j " ,�Url
2. Please list all owners, occupants, or parties in interest of
the property: I r C - a VE
L0.1KR� �, M�F��l�rlcl -
DEPT. OF PLANNING/DEVELOPMENT
3. The property is located at: (please give exact directions and
include the route number of your road or street)
P2c�c -'S on,k-gs cm -,A kk '--n wesi- Gi C C32own CeAa e- s l A• n< �\Ovykf 6A
4. The property has a road frontage of 353.8)� feet and a
depth of loop, q-t feet and consists of C; . tc, acres.
(Please be exact)
(r(lA(le� MoR6Ag -}irre of Wn )�
5. The property is owned by k"kke .4. 1 ,e tA( RL'zLCLn as
evidenced by deed from V9 ,-t p An 5�-Agon Lon n recorded
(previous owner)
in deed book no. on page t 5 ,L4 as recorded in the
records of the Clerk of the Circuit Court, County of
Frederick.
6. - Property Identification No. 51 - fl- 7'pE
Magisterial District cle
Current Zoning 1?er4
7. Adjoining Property:
USE ZONING
North Vacaaii +:+1n ,zi¢
East R!E�.ICle0r-e-- QAtk OzrhA111�x
South Res irlence- - LAmk e+- le,4
West Vk ftrNr i hr NQ i L 44
1
S. The type of use proposed is (consult with.the Planning Dept.
before completing)
scc)-a\\ J enQ�AVkl2Li� 1�nS�c�i2� �ry�ne
9. It is proposed that the following buildings will be
constructed: tit
10. The following are all of the individuals, firms, or
corporations owning property adjacent to both sides.and rear
and in front of (across street from) the property where the
requested use will be conducted. (Continue on back if
necessary.) These people will be notified by mail of this
application:
_I S-4-e�hc�s
�uF NAME CArcoL 1� � � � T ADDRESS �311 (� �dalc Pc) Cal "
PROPERTY ID# b9 A 10 F
20 p NAME l �o,, 5 �. LAm6e Kt ADDRESS 38O1.n (.c� (LdeOScx A e G(r'Ae A
PROPERTY ID#
5`7 A NAME E RKK 4-ylr&%n4 &U,Segynao ADDRESS WaeAexlol le arcSe (10
PROPERTY ID# �p9fl 5A
2�ZZ,z3 A NAME ,SQz,A�A -T. Cqe (U�.'4' ADDRESS '140 (�e v C1�GIe , ES�es c`z��
Co�O�CL6O
PROPERTY ID# Sok A, SoS I*�
NAME ADDRESS
PROPERTY ID#
NAME ADDRESS
PROPERTY ID#
NAME ADDRESS
PROPERTY ID#
NAME ADDRESS
PROPERTY ID#
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12. Additional comments, if any:
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I (we), the undersigned, do hereby respectfully make application
and petition the governing body of Frederick County, Virginia to
allow the use described in this application. I understand that the
sign issued to me when this application is submitted must be placed
at the front property line at least seven (7) days prior to the
first public hearing and maintained so as to be visible until after
the Board of Supervisors' public hearing. Your application for a
Conditional Use Permit authorizes any member of the Frederick
County Planning Commission, Board of Supervisors or Planning and
Development Department to inspect your property where the proposed
use will be conducted.
Signature of Applicant 11-1 6ACe'tta o ►" J f0jZ-&-f Y-Icl _.
Signature of Owner
Owners' Mailing Address � ��)���er�sv��% 6�02ef &J[(r, V /7
Owners' Telephone No. %j�{U y-�-7— gjS
TO BE COMPLETED BY ZONING ADMINISTRATOR:
USE CODE:
RENEWAL DATE:
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REQUEST FOR CONDITIONAL USE PERMIT COMMENTS
Virginia Department of Transportation
Attn:. Resident Engineer
14031 Old Valley Pike r- _ E ,„ ;,,�.,
Edinburg, Virginia 22824 " " {� \'J
(540) 984-5600 O C T ; 1999
The local office of the Transportation Department is located at 1550 ComEff, e� St. in Winchester
if you prefer to hand deliver this form. t./ CVCLOPMENT.
Applicant's name, address and phone number:
Name of development and/_or description of the request:
nc,CSA -JCoF . \ br 2- Rvr'.\ys 1 n vYALA e%--n `lorne -\z) a e� Q..\anc
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Se?ru�c �• Cmm(ZCG
Location:
0 oyCE X � ry,:\es o,,E- �Z-\ Sa k a lesV. TLLy—n 1e-c-� or\L V -l. T
l.h \e ns„k e G-yuAL) L, o p pec, (� �1rx\,\, s nc s; mN-
&Qr ,2n C2C�``_gL<- Inca 0t Grp S�2 (W 9,b\fi-k) , Ene Ay-e-es c` go
kA 2v
Va. Dept. of Transportation Comments:
No objection to conditional/special use permit for this property. Existing
entrance is adequate for proposed use. However, should use ever expand in the
future the entrance may have to be upgraded to VDOT minimum commercial
standards.
VDOT Signature and Date: 61- YZ6e O
(NOTICE TO RESIDENT ENGINEER*PLEASE RETURN THIS FORM O APPLICANT.)
NOTICE TO 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.
h
REOUEST FOR CONDITIONAL USE PERMIT COMMENTS
Frederick County Inspections Department
Attn: Building Official
107 North Kent Street
Winchester, Virginia 22601
(540) 665-5650
The Frederick County Inspections Department is located at 107 North
Kent Street, 4th Floor of the County Administration Building in
Winchester, if you prefer to hand deliver this review.
Applicant's name, address and phone number:
AM-4 MIF�
37Ra LJAnd ens vide
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LJ��2ch�3
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Name of development and/or description of the request:
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aald ar '� I k .I in � cz, (Pt din P ' 6 n 5 u,14 rh e"►-Y, "r f
ace '' T-L-n�0&--& c,i-eF_ net s el S6-�zulcE a't'E al
Location: y aFfE2 he E c�v �,�
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Inspection Department Comments:
Conmients are on the back of this form.
Code Administrator Signature & Date: (�$��=2'�/
(NOTICE TO INSPECTIONS DEPT.*PLEASE R9TVN THI ORM TO PLIC TJ
NOTICE TO 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 a copy of your application form, location map and all
other pertinent information.
i56ri.1�3an:Y3G/SA.Y...A�'E5i^r .�1. 'G?`-fASc^ =z.�_
OCT 12 1J9
FREDERIOK CO,
PUBLIC WORt(S & INSPE(0T190N,8
i
Area of building
Building Gcde and
plan of the area
the International
buildings.
to be utilized shall comply with the Virginia
The BOCA National Building Code/1996.'-Please
for a change of use building permit. Note the
Mechanical Code for the proper air change for
Uniform Statewide
submit a floor
reauirements in
kennels within
RECEIVED OCT 1 2 1999
REQUEST FOR CONDITIONAL USE PERMIT COMMENTS
Frederick County Fire Marshal J
�• � 21 ATTN: Fire Marshal
107 North Kent Street
Winchester, Virginia 22601
(540) 665-6350
The Frederick County Fire Marshal is located at 107 North Kent
Street, 1st floor of the County Administration Building in
Winchester, if you prefer to hand deliver this review form.
Applicant's name, address and phone number:
3��P/xu�ll� G�d� CJfr� Lazy
Name of of development and/or description of the request:
/. 1'. e I /i //inn -b) A �n-xll 6fincl� d-r i" oyn to or
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Location:
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gwzcf)� 3 rn, /,e-5 aLf 5,o 7o-lea an I u8 L#rdPns�� lle
mr 7 rn L es pXss wr r (%,�r►s ss s.� ) /J'2�c art �ecaC� �Sr d�J
Ak{)
Fire Marshal Comments:
Fire Marshal Signature & Date
(NOTICE TO FIRE MARSHAL - PLEASE RET THIS FORM TO APPLICANT.)
NOTICE TO 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 a copy of your application form, location map and any
other pertinent information.
s
COUNTY OF FREDERICK, VIRGINIA
FIRE MARSHAL'S OFFICE
LAND DEVELOPMENT COMMENTS
Control No. CUP99-0028 Date Received 10/12/99 Date Reviewed 10/25/99
Applicant Nanette McFarland
Address 3782 Wardensville Grade
Winchester, Va. 22602
Project Name Tender Care Petsitting Service Phone No. 540-877-2745
Type of Application Conditional Use Current Zoning RA
1st Due Fire Co. 19 1st Due Rescue Co. 19 Election District Back Creek
Tax I.D. No. 59-A-20E
RECOMMENDATIONS
Automatic Sprinkler System Residential Sprinkler System
Automatic Fire Alarm System Other : Smoke Detectors & Fire Ext.
REQUIREMENTS
Emergency Vehicle Access
Adequate XX Inadequate Not Identified
Fire Lanes Required Yes No XX
Comments: Emergency vehicle access maintained, width and overhead
clearances to accommadate fire apparatus.
Roadway/Aisleway Widths Adequate XX Inadequate Not Identified
Special Hazards Noted Yes No XX
Comments
Hydrant Locations Adequate Inadequate Not Identified XX
Siamese Location Adequate Inadequate Not Identified XX
Additional Comments Attached? Yes No XX
Plan Approval Recommended? Yes XX No
Signature ^.����� Titlei�.z c����
31gO
REQUEST FOR CONDITIONAL USE PERMIT COMMENTS
Winchester -Frederick County Health Department
107 North Dent Street, Suite 201
Winchester, Virginia 22601
(540) 722-3480
The Winchester -Frederick County Health Department is located in the County Administration
Building at 107 North Kent Street in Winchester, if you prefer to hand delivered this form.
Applicant's name, address and phone number:
rq
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(SV6) 2D7 - )L7 q S
Name of development and/or description of the request:
4I01t1<1 bite -L aG� sVn�11 ke�r� inst�fay��h� h�rrre.,yye �� 1 �r a
I lu 5 i„ my A nn-k 4r„ MOO s ck)f�'h /KV Qfs, A19r h«���� 17- of
5'6zuICE ( JL-;& Cho ,,;� • hok -new- --�6 e"('fee-
Location: JJ
56
2cx�r► C�cCcv sicl �hk - PilC h1-h5zc�n�k'�
Health Department Comments:
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41
Signature and Date:
NOTICE TO 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 a copy of your application form, location map and
all other pertinent information.
REQUEST FOR CONDITIONAL USE PERMIT COMMENTS
Frederick County Sanitation Authority
Attn: Engineer Director
P.O. Box 1877
Winchester, Virginia 22604
(540) 868-1061
The Frederick County Sanitation Authority is located at 315 Tasker Road in Stephens City, Virginia,
if you prefer to hand deliver this review.
Applicant's name, address and phone number:
NMA17t' 1h6FVrbgM
?2 L.49kat�91
2
[��ir�chGs-f IIrY9 a-pLt co,
3.7.7- 9-7 q5
Name of development and/or description of the request:
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;5gu cCE r
Location:
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65 AUR- x I mi l-� (,P/Iffys Mr tjIr Ir1)-nr 5-1�,j ) kt kacc-;rgg 5 /0eL)
&m on 4he Rahn — 120'6 --fags 610n�E f�n-1 UtqrD
Sanitation Authority Comments:
NO C014AIAI
Sanitation Authority Signature &Dater.. , ,�
(NOTICE TO SANITATION AU ft6RITY * RETURN THIS FORM TO APPLICANT.)
NOTICE TO 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 a copy of your application form, location map and all other
pertinent information.
Gkfin-, 1