HomeMy WebLinkAboutZP-19-026 - 1233 Shelburne Road 2/11/2019CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
' 11 _02.0
Applicant: ._.. Application No:
[office use only]
Applicant Mailing Address:
Applicant Email: tDaytime phone:
Property Street Address: lown,
VT 05403
Property Owner: Parcel Size:
Property Owner Mailing Address: 3 Tax Parcel ID No.
1. PROPOSED project including jayilding dimensions (describe):
2/ 'resent USE(S) of the property:
j 0 Single family home on its own parcel
Other (please state the YSE per Land Development Regulations- retail, general office, multifamily residential, etc.):
3. List all present structure(s) on property (describe including dimensions or square footage of each):
4. Does the project include a proposed change of USE?
O No (the property will still be used for the same purpose)
O Yes (please state proposed changed or added USES per Land Development Regulations- retail, general
office, multifamily residential, etc.): /
5. ESTIMATED total cost of improvements (materials and labor): $
6. Building footprint — i.e. size in sq. ft. of main floor of house and all attached and detached structures including enclosed
breezeways, garages, and sheds (describe): Existing: Proposed:
7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks)
Existing: Proposed:
'TTACH SKETCH PLAN OR SITE PLAN (not required if project consists ONLY of interior renovations or replacement of
existing roof, siding, etc. in the exact same size)
9. APPLICANT/OWNER CERTIFICATION
The undersigned property owner hereby consents to submit this application and understands that if the application is approved,
the Zoning Permit and any attached conditions will be binding on the property.
tA
PropOrty Ow er ft t r .> PRINT NAME Date /
�u gn al3plicant here y,affirms that the information presented in this application is true, accurate and complete.
Jv
" P q
WWSidTfaYure PRINT NAME Date
OFFICE UQ, ONLY — ADMINISTRATIVE OFFICER ACTION — OFFICE USE ONLY
DATE Received: 2l I 1 FEE Received: $ �Iti i' �?j Identification of zoning district:
Identification of proposed use:
f�:iiTli�9�1r1>tbY�I�IT�I
Date of SITE PLAN approval/denial
Date of SUBDIVISION approval/ denial
Date of CONDITIONAL USE approval/ denial
Date of appeal VARIANCE approval/ denial
Date of MISCELLANEOUS approval/ denial
Permitted
Approval Date
Approval Date
Approval Date
Approval Date
Conditional
Denial Date
Denial Date
Denial Date
Denial Date
Approval Date Denial Date
❑ Provided applicant copy of URBEC or VCBE Standards Handbook or X Not Applicable
FINAL ADMINISTRATIVE OFFICER ACTION
Z O N I N G P E R M I T
APPROVED
Approval Date Administrative Officer's Signature
Permit EFFECTIVE date 2 �P Permit EXPIRATION date Z' O 702-D
❑ DENIED REASON for DENIAL
Denial Date
Administrative Officer's Signature
Notice of Appeal Rights: Any interested person may appeal this decision by filing a written Notice of Appeal with the clerk of the
Development Review Board within fifteen [15] days of the date of this decision. The notice of appeal must be accompanied by a filing
fee of $223.00.
This permit does NOT authorize commencement of any development activity approved by the permit until the permit takes(
effect as set forth above. Site modifications and improvements made prior to this permit becoming effective may be subject to rem
and site restoration if a timely appeal is commenced.
NOTE: The applicant or permittee retains the obligation to identify, apply for, and obtain relevant state permits for this project. Call
(802) 477-2241 to speak with the regional Permit Specialist.