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HomeMy WebLinkAbout19-11 Applicationr , 0 • SITE PLAN APPLICATION - Ojfice Use Only - Date Application Received: Application Fees Received: l� Receipt #.. initials,: 1. Project Title: 2. Location of Property U (Street address) 3. pplicanUDesi r: c�� /r1, �Cse,c_ 03 573 -72 z Name: G Telephone: 7G Address: 4. Property Owner (if different than above): Name: U �l '. J� Zl Address: 6 o / 5. Pro a. b. C. d. e. f. v/ >erty Information: Property Identification Number: Total acreage of the parcel to be developed Total disturbed area of the parcel: Present Use: Proposed Use: Magisterial District(s) 8 Telephone: -703 `/07'3 3--4- E C9 JUN 2 3 2011 M Pik 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 ininor site plan? If yes provide all previous site plan numbers: 0 Yes No Yes ✓ No Yes ✓ / No 7. Zoning Information: a. Current Zoning: K 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? Yes No V/ f. If yes provide the MDP number for this property: 8. 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 Department. I also under td that all required material will be complete prior to the submission o Signature: Date: 9 ounty Planning my site plan. Il i 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 & 107 North Kent Street- 2nd Winchester, Virginia 2260 Applicant: It is your responsibility to complete this form as accurately as possible in order to assist the age cy with their j review. Please attach two (2) copies of the Site Plan with this sheet.-,, , u Applicant's Name: W �n�� m t2 /Telephone: Mailing Address: LG ekzI)AGA k/& 74 45!0 Name of development and /or description of the request: 4" fY6�Y /o Location of Property: -E-5-0 �t 2 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:V • * Please`Retnrn�Fcrm to Applicant"* 16 JUL 5 2011 a' - K co -� Special Limited Power of Attorney c4 G��` '• County of Frederick, Virginia Frederick Planning Website: www.co.frederick.va.us „WAN Department of Planning & Development, County of Frederick, Virginia I 107 North Kent Street, Winchester, Virginia 22601 Phone (540) 665 -5651 Facsimile (540) 665 -6395 I Know All Men By These Presents: That I (We) f� c�ra;r5 tt�Q5hyh5 -00 A Ipu-h qvi ehhN$ c{o 3,.342 (Name) (rill i vi.;TO� 64S Ctldw Sn -Cti0 t��luPr--(Phone) 703750 5- �'q4 (Address) 1pfjQ/ Z4lJL�USI f�1+4� �S�d� Si�Qtuy� �%4 ZZ,sf, the owner(s) of all those tracts or parcels of land ("Property ") conveyed to me (us j, by deed 'recorded in the Clerk's Office of the Circuit C urt of the County of Frederick, Virginia, by eECO�I� _-,6 --0 q10 z1 Instrument No. on Page and is described as Parcel: Lot: ,.Z Block: Section:( Subdivision: 0), t5y f�UVs�fl G/IQ� do hereby make, constitute and appoint: (Name) //d ry/ / lS-o yL f� (Phone) %(�? CIU `� y 72 Y (Address) 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 otherwis resandeETorrnodified. In witness thereof, I (we have hereto set my (our) hand and seal this J O day of Signature(s) State of `Virginia, City/County of To -wit: r T 1 I, Ij e L _. a Notary Public in and for the jurisdiction aforesaid, ce� that the person(s) who signed to the foregoing instrument ersonally appeared before me and has ack owledged the Arne before me in the jurisdiction aforesaid this � day of � vy C , 20 1 —d My Commission Expires: 03