HomeMy WebLinkAbout01-26 Application6
AAPPLICATIONN FORR CONDITIONALL USEE PERMIT
FREDERICKK COUNTY,, VIRGINIAA
_____________________________________________________________________________
1. Property Owner(s) (please attach additional page(s) if more than two owners):
Name:
Specific Contact Person if Other than Above:
Address:
Telephone: Email:
Name:
Specific Contact Person if Other than Above:
Address:
Telephone: Email:
2. Other Interested Parties (such as a contract purchaser) (please attach additional
page(s) if necessary):
Name:
Specific Contact Person if Other than Above:
Address:
Telephone: Email:
3. Law firm, engineering firm, or other person, if any, serving as the primary contact person
for this application:
Firm Name:
Specific Contact Person at Firm:
Address:
Submittal Deadline __________
P/C Meeting __________
BOS Meeting __________
Ricky E. Chase
Eric A. Chase
541 Ruebuck rd, clear brook, va 22624
540-409-8341 ericchase9415@gmail.com
Eric A. Chase
541 Ruebuck rd, clear brook, va 22624
540-409-8341 ericchase9415@gmail.com
7
Telephone: Email:
4. The property has a road frontage of __________ feet and a depth of __________ feet
and consists of __________ acres. (Please be exact)
5. The property is owned by ________________________________________ as
evidenced by deed from ___________________________ (previous owner) recorded
in deed book no. ________ on page ________, as recorded in the records of the Clerk
of the Circuit Court, County of Frederick.
6.___
7. Adjoining Properties:
Zoning:Use:
North:
South:
East:
West:
8. Conditional use(s) proposed: (cconsult with the Planning Dept. before completing):
_______________________________________________________________________
9. Describe, if applicable, any new buildings to-be-constructed associated with this use
(attach additional documentation as necessary):
_______________________________________________________________________
________________________________________________________________________
10. The following are all of the individuals, firms, or corporations owning property
adjacent to all sides (including across street from) the property where the
requested use will be conducted. These people will be notified by mail of this
application:
NName and Property Identification Number AAddress
Name
Property #
Name
Property #
118 352
1
Ricky E. Chase
Ricky E. Chase
Property Identification Number(s) (P.I.N.):___23-4-3-5 ___
Magisterial
District:____Gainesboro___________________________________________________ Current
Zoning:______RA ____________________________________________________
RA residential
RA residential
RA residential
unavailable agriculture/ business
Public Garage
Phillip Dodson
23 4 3 6
Darrel Shaw
23 4 3 4
553 Ruebuck Rd, Clear Brook, VA 22624
529 Ruebuck Rd, Clear Brook, VA 22624
& Susan Alane Phillip
& Lonnie Sue Shaw
8
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
Name
Property #
10. Please attach a sketch of the property (refer to “Application Steps”).
11. Please attach a written description of the proposed use (refer to “Application Steps”).
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.
*All owners listed on the property record shall sign the application.
Signature of Applicant _____________________________________________________
Signature of Owner(s) ______________________________________________________
Mitchell Shumaker
23 5 G
151 Sassafras Ln, Clear Brook, VA 22624& Debbie Kane
9
______________________________________________________
Owners' Mailing Address ____________________________________________________
Owners' Telephone No. ____________________________________________________
*A signed Power of Attorney form is required if someone is signing on the owner(s) behalf.
541 Ruebuck rd, Clear Brook, Va 22624
540-409-8341
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