HomeMy WebLinkAboutZP-18-280 - 0006 Worcester Street 7/13/2018CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
Applicant: t `- '
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Applicant Mailing Address:
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Applicant Email:
Property Street Address:
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Property Owner:
Property Owner Mailing Address:
Application No:
6�� h [office use only]
�,wC4';01 Daytime phone:
Parcel Size:
Tax Parcel ID No
VT 05403
1. PROPOSED project including building dimensions (describe):
CP4'�;7 /I /),i/,o "� � /f l-, -5-""52
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.):
3. List all present structure(s) on property (describe including dimensions pr square footage of each):
4. Does the project include a proposed change of USE?
4❑No (the property will still be used for the same purpose)
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): $ 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:
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)
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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, the
Zoning Pe i d any attached c nditions wil be binding on the property.
Property O ner Signatur PRINT NAME Date
The undersigned applicant hereby affirms that the information presented in this application is true, accurate and complete.
Applicant Signature
PRINT NAME
Date
OF/ICE USE ONLY — ADMINISTRATIVE OFFICER
ACTION — OFFICE USE ONLY
DATE Received: ! FEE Received: $ / / Identification of zoning district:
Identification of proposed use:
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 orE]Not Applicable
0
APPROVED
FINAL ADMINISTRATIVE OFFICER ACTION
ll�giO N IN R1h�
Permit EFFECTIVE date
1-1 DENIED
Denial Date
Officer's Signature Permit EXPIRATION date ` %
/� /
REASON for DENIAL
Admin
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.
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