HomeMy WebLinkAboutZP-18-357 - 1210 Williston Road 9/10/2018CITY OF SOUTH BURLINGTON
Z O N I N G PERM IT APPLICATION
Applicant: S/ab l �) av1 A Application No: ZA -I& --�s
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Applicant Mailing Address: �1 QtiIU C(, i
Applicant Email: I����C'G4� Daytime phone: (a2 )y"'- D
Property Street Address: 1( C"'t N 1'-q [ 0U 1� � , VT 05403
Property Owner: �-r 1' \i' F '4 I� Parcel Size:
Property Owner Mailing Address:�U.J� ���(� Tax Parcel ID No.
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1. PROPOSED project including building dimensions (describe):
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2. Present USE(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.):
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3. List all present structure(s) on property (describe including dimensions or square footage of each):
4. Doe the project include a proposed change of USE?
No (the property will still be used for the same purpose)
es (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):
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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:
8. ATTACH 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. j
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Property wn i
r Signature PRINT NAME Date
The undersigned applicant hereby affirms that the information presented in this application is true, accurate and complete.
Applicant
i 1, 1
PRINT NAME
Date
OFFICE USE ONLY — ADMINISTRATIVE OFFICER ACTION — OFFICE USE ONLY
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DATE Received: tO 19 FEE Received: $ 45 Identification of zoning district:
Identification of proposed use: tt,5 4W ll
PROPOSED USE TYPE: =Permitted Conditional
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 i of Applicable
FINAL ADMINISTRATIVE OFFICER ACTION
Z O N I N_ Gi P/ E R M I T
APPROVED_
Approval Date ` p Administrative Officer's Signature c,
Permit EFFECTIVE date //� 0 Permit EXPIRATION date
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DENIED REASON for DENIAL
Denial Date
ministrative_Officer's _Signature
Notice of Appeal Rights: Any interested person may appeal this decision by filing a written Notice of Appeal with 'he clerk of the
Development Review Board within fifteen 115] 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)
I 879-5676 to speak with the regional Permit Specialist.