HomeMy WebLinkAboutZP-19-011 - 0580 Country Club Drive 1/16/2019CITY OF SOUTH BURLINGTON
Z O N I N G PERM IT APPLICATION
Applicant:
Applicant Mailing Address:
Applicant Email:
Application No:
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Property Street Address: en L- U-0 L'A' ),�—t/1 / (�Ij A U)- , VT 05403
Property Owner: Parcel Size:
Property Owner Mailing Address: �/��' Tax Parcel ID No.o �S$�
1. PROPOSED project including building dimensions (describe):
Present SE(S) of the property:
Single family home on its own parcel
❑ Other (please state the USE 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 (the property will still be used for the same purpose)
Ryes (please state proposed changed or added USES per Land Development Regulations- retail, general
office, multifamily residential, etc.):
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5. ESTIMATED total cost of improvements (materials and labor): $ (Z� Z
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:
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7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks)
Existing: Proposed:
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8. ATTACH SKETCH PLAN OR SITE PLAN (not required if project consists ONLY of interior renovations or replacement of
I existing roof, siding, etc. in the exact same size)
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9. APPLICANT/OWNER CERTIFICATION
The undersigned property owner hereby consents to submit this application and understands that if the application is approved, thr
Zoning Permit aDd any attached conditiogs will be binding on the property. 1
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Property O'ner Signature INT NAME Date
The undersigned applicant hereby affirms Jthattformation presented in this application is true, accurate and complete.
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ADDlicant Signature PRINT NAME Date
OFFICE USE ONLY - ADMINISTRATIVE �OFFICER ACTION - OFFICE USE ONLY
DATE Received: FEE Received: $-I Identification of zoning district:
Identification of proposed use:
PROPOSED USE TYPE:
PermittedConditional
Date of SITE PLAN approval/denial
Approval Date Denial Date
Date of SUBDIVISION approval/ denial
Approval Date Denial Date
Date of CONDITIONAL USE approval/ denial
Approval Date Denial Date
Date of appeal VARIANCE approval/ denial
Approval Date Denial Date
Date of MISCELLANEOUS approval/ denial
Approval Date Denial Date
Provided applicant copy of URBEC or VCBE Standards Handbook or,®Not Applicable
FINAL ADMINISTRATIVE OFFICER ACTION
G Z I N G P E R &I T
FViAPPROVED I' 4 1 __
Approval Date Administrative Officer's Signature
Permit EFFECTIVE date 131 1 f 9 Permit EXPIRATION date
1-1 DENIED
Denial Date
REASON for DENIAL
Administrative Officer's Signature
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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 removal
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)
879-5676 to speak with the regional Permit Specialist.