HomeMy WebLinkAbout06-12 ApplicationI
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SITE PLAN APPLICATION
- office Use Only -
Date Application Received: � Application #:
Fees Received: Receipt H: I�T J . Initials:
Project Title: Li
Location of Property
(Street address)
ApplicanUDesibmer: y /�
Name:
Address:
Telephone:��
I
4. Property Owner (if different than above):
Name: Telephone:
Address:
5. Property Information: r\ t
a. Property Identification Number: r,,'
b. Total acreage of the parcel to be developed: io
C. Total disturbed area of the parcel: 3
d. Present Use:
e. Proposed Use:
f. Magisterial District(s)
8
0
Site Plan Type:
a. Is this an original or new site plan? Yes II No
b. Is this a revised site plan? Yes El No
If yes provide all previous site plan numbers:
c. Is this a minor site plan? Yes II No
If yes provide all previous site plan numbers:
Zoning Information:
a. Current Zoning: til1A,
b. _ Was this property Rezoned? Yes F-1 No i%
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 n No FA
f If yes provide the MDP number for this property:
Adjoining property zoning and use:
USE ZONING
North Act{ I. U
East ;.all
South
West
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:
Date: I ?I Z-
r- 1
LJ
Special Limited Power of Attorney
County of Frederick, Virginia
Frederick Planning Website: www.co.frederick.va.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) ry
(Address) 8Qx� J`4 errs vLl(t �, s - ��,ln. 4 u . 277
the owner(s) of all those tracts or parcels of Iiind ( "Property ") conv ed to me (us), by deed recorded in the
Clerk's Office of the Circuit Court of the County of Frederick, Virginia, by
Instrument No. � � ly, on Page � f-1. t7 and is described as
` A - 4-A
Parcel: Lot: Block: Section: Subdivision:
do hereby make, constitute and appoint:
(Name) 11'�b;gbYQn� (Phone) �U Q74 1MZ
(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)
F Conditional Use Permit
Development Plan (Preliminary and Final)
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 t} i¢ otherwise rescinded or modified.
In witness thereo , I (we) have hereto
7 set my (our) hand and seal this o76'/ /"day of MtAac,& 20_�-
Signature(s) � % U /G(/(�-c�
State of Virginia, City/County of To -wit:
11 a Notary Public in and for the jurisdiction aforesaid,
certify that the person(s) who signed to the foregoing instrument personally appeared before me and has
a wle d "fly same e re me in the jurisdiction aforesaid this '-day of � 20 (Q
My Commission Expires: IJ -
ary Publ'