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Home My WebLink AboutSD-18-18 - Supplemental - 0068 Nesti Drive (10) 575 Dorset Street South Burlington, VT 05403 tel 802.846.4106 fax 802.846.4101 www.sburl.com Permit Number SD-______-__________ (office use only) APPLICATION FOR SUBDIVISION PLAT REVIEW □ Preliminary □ Final PUD Being Requested? □ Yes □ No All information requested on this application must be completed in full. Failure to provide the requested information either on this application form or on the plans will result in your application being rejected and a delay in the review before the Development Review Board. 1. OWNER(S) OF RECORD (Name(s) as shown on deed, mailing address, phone) ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 2. LOCATION OF LAST RECORDED DEED (Book and page #) ___________________________________________ 3. APPLICANT (Name, mailing address, phone) _____________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 4. CONTACT PERSON (Name, mailing address, phone) _______________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ a. Contact email address: ________________________________________________________________ 5. PROJECT STREET ADDRESS: __________________________________________________________________ 2 Subdivision Application Form. Rev. 5-2018 6. TAX PARCEL ID # (can be obtained at Assessor’s Office) ___________________________________________ 7. PROJECT DESCRIPTION a. General Project Description (describe what you are proposing): __________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ b. Existing Uses on Property (including description and size of each separate use): ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ c. Proposed Uses on property (include description and size of each new use and existing uses to remain): ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ d. Total building square footage on property (proposed buildings and existing buildings to remain): ___________________________________________________________________________________________ ___________________________________________________________________________________________ e. Height of building & number of floors (proposed buildings and existing buildings to remain, specify if basement and mezzanine): _________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ f. Number of residential units (if applicable, new units and existing units to remain): ___________________________________________________________________________________________ ___________________________________________________________________________________________ g. Number of employees (existing and proposed, note office versus non-office employees): ___________________________________________________________________________________________ ___________________________________________________________________________________________ 3 Subdivision Application Form. Rev. 5-2018 h. Other (list any other information pertinent to this application not specifically requested above, please note if Overlay Districts are applicable): ________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ i. List any changes to the subdivision, such as property lines, number of units, lot mergers, etc. ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 8. LOT COVERAGE (ALL information MUST be provided here, even if no change is proposed) a. Size of Parcel: ___________________________ (acres /sq. ft.) b. Building Coverage: Existing __________ square feet __________ % Proposed _________ square feet __________ % c. Overall Coverage (building, parking, outside storage, etc): Existing __________ square feet __________ % Proposed _________ square feet __________ % d. Front Yard Coverage(s) (commercial projects only): Existing __________ square feet __________ % Proposed _________ square feet __________ % 9. WETLAND INFORMATION a. Are there any wetlands (Class I, II, or III) on the subject property? □ Yes □ No b. If yes, is the proposed development encroaching into any of these wetlands associated 50’ buffers (describe) _____________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 4 Subdivision Application Form. Rev. 5-2018 c. If yes, please submit the following with this application: 1. A site specific wetland delineation of the entire property or a written statement that the applicant is relying on the City’s wetland map. 2. Response to the criteria outlined in Section 12.02(E) of the Land Development Regulations (applicant is strongly encouraged to have a wetland expert respond to these criteria) 10. AREA DISTURBED DURING CONSTRUCTION: ___________________SQ. FT. * *Projects disturbing more than one (1) acre of land must follow the City’s specifications for erosion control in Article 16 of the Land Development Regulations. Projects disturbing more than one (1) acre require a permit from the Vermont Department of Environmental Conservation. 11. COST ESTIMATES a. New Building or Addition, including initial fit-up. (If fit-up not available, contact Planning & Zoning staff) $____________________ b. Landscaping: $____________________ (Please submit itemized list of landscaping proposed) c. Other site improvements (please list with cost) __________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 12. ESTIMATED TRAFFIC a. P.M. Peak hour for entire property (In and out): ___________________________________ 13. PEAK HOURS OF OPERATION: ____________________________________________ 14. PEAK DAYS OF OPERATION: ______________________________________________ 15. ESTIMATED PROJECT COMPLETION DATE: _______________________________ 16. PLANS AND FEE Plat plans shall be submitted which shows the information required by the City’s Land Development Regulations. Three (3) regular size copies, one reduced copy (11" x 17"), and one digital (PDF-format) copy of the plans must be submitted. A subdivision application fee shall be paid to the City at the time of submitting the application. See the City fee schedule for details. NOTE: NOTIFICATION of ADJOINING PROPERTY OWNERS: Notification of adjoining property owners, in accordance with 24 V.S.A. §4464(a) and Section 17.06(B) of the South Burlington Land Development Regulations, is the responsibility of the applicant. After deeming an application complete, the Administrative Officer will provide the applicant with a draft meeting agendas or public hearing notice and sample certificate of service. The sworn certificate of service shall be returned to the City prior to the start of any public hearing. I hereby certify that all the information requested as part of this application has been submitted and is accurate to the best of my knowledge. SIGNATURE OF APPLICANT SIGNATURE OF PROPATY OWNER PRINT NAME Do not write below this line DATE OF SUBMISSION: I have reviewed this preliminary plat application and find it to be: Complete Incomplete Administrative Officer Date The applicant or permittee retains the obligation to identify, apply for, and obtain relevantstote permits for this project. Call (802) 879-5676 to speak with the regional Permit Specialist. 5 Subdivision Application Form Rev. 5-2018