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Home My WebLink AboutSD-18-33 - Supplemental - 1200 Airport Drive (6) 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 SKETCH PLAN REVIEW 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. For amendments, please provide pertinent information only. 1) OWNER(S) OF RECORD (Name(s) as shown on deed, mailing address, phone and fax#) ________ ____________________________________________________________________________________ ____________________________________________________________________________________ 2) LOCATION OF LAST RECORDED DEED(S) (Book and page #)__________________________ 3) APPLICANT (Name, mailing address, phone and fax #)____________________________________ ____________________________________________________________________________________ 4) APPLICANT’S LEGAL INTEREST IN THE PROPERTY (fee simple, option, etc.)___________ ____________________________________________________________________________________ 5) CONTACT PERSON (Name, mailing address, phone and fax #)_____________________________ ____________________________________________________________________________________ 5a) CONTACT EMAIL ADDRESS _______________________________________________ 6) PROJECT STREET ADDRESS:_____________________________________________________ ____________________________________________________________________________________ 7) TAX PARCEL ID # (can be obtained at Assessor’s Office)_________________________________ 8) PROJECT DESCRIPTION a) General project description (explain what you want approval for): __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ 2 Sketch Plan Application Form. Rev. 12-2011 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) Proposed height of building (if applicable) ______________________________________________ f) Number of residential units (if applicable, new units and existing units to remain) _______________ ____________________________________________________________________________________ g) Other (list any other information pertinent to this application not specifically requested above, please note if Overlay Districts are applicable)______________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 9) LOT COVERAGE a) Building: Existing________ % Proposed_________% b) Overall (building, parking, outside storage, etc) Existing________% Proposed_________% c) Front yard (along each street) Existing________% Proposed_________% 10) TYPE OF EXISTING OR PROPOSED ENCUMBRANCES ON PROPERTY (easements, covenants, leases, rights of way, etc.)______________________________________________________ ____________________________________________________________________________________ 11) PROPOSED EXTENSION, RELOCATION, OR MODIFICATION OF MUNICIPAL FACILITIES (sanitary sewer, water supply, streets, storm drainage, etc.)________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 3 Sketch Plan Application Form. Rev. 12-2011 12) ESTIMATED PROJECT COMPLETION DATE______________________________________ 13) PLANS AND FEE Plat plans shall be submitted which shows the information required by the City’s Land Development Regulations. Five (5) regular size copies, one reduced copy (11" x 17"), and one digital (PDF-format) copy of the plans must be submitted. The 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 PROPERTY OWNER ____________________________________________________________________________________ Do not write below this line DATE OF SUBMISSION:__________________________________ I have reviewed this sketch plan application and find it to be: Complete Incomplete ________________________________________________________ Administrative Officer Date The applicant or permittee retains the obligation to identify, apply for, and obtain relevant state permits for this project. Call (802) 879-5676 to speak with the regional Permit Specialist.