HomeMy WebLinkAboutZP-18-143 - 0011 Moss Glen Lane 4/27/2018CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
Applicant: ?eul �� . ^ nei Application No: Z�— ze —/
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Applicant Mailing Address: -L�jr) }L- �` ��V��vV� Iil i) �'C
Applicant Email: MY�1J�i� Cl)Y �l Daytime phone: 2 &Lf !S`
Property Street Address: it !�cys� r���� l,r��.�e �c���1�"���C ncc��)r1 VT05403
Property Owner: v f� �C/t Parcel Size:
Property Owner Mailing Address: G Wt l l tX r Tax Parcel ID No.
1. PROPOSED project including building dimensions (describe):
V1,tA.
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 or square footage of each):
4. Does the project include a proposed change of USE?
co (the property will still be used for the same purpose)
QYes (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): $ �1 `" I 1
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)
I
9. APPLICANT/OWNER CERTIFICATION
The undersigned property owner hereby consents to submit this application and understands that if the application is approved, the
bning Permit and any attached conditions will be binding on the property.
Signature
PRINT
Date
The ndersigned applicant hereby affirms that the information presented in this application is true, accurate and complete.
4 W�v C'o1 - bd& `f ;�
scant &nature PRINT IIJAME Date
OFFICE U E ONLY — ADMINISTRATIVE O F C�R ACTION — OFFICE USE ONLY
DATE Received: 4 9 11f FEE Received: $ Identification of zoning district:
Identification of proposed use:
PROPOSED USE TYPE: '[ZfPermitted 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
1
Approval Date Denial Date
Date of appeal VARIANCE approval/ denial
Approval Date Denial Date
Date of MISCELLANEOUS approval/ denial
Approval Date Denial Date
rovided applicant copy of URBEC or VCBE
Standards Handbook or❑Not Applicable
FINAL ADMINISTRATIVE OFFICER ACTION
Z O N I E T
APPROVED
pproval [late Ad n ztive Officer's Signature
Permit EFFECTIVE date / Permit EXPIRATION date
DENIED
Denial Date
REASON for DENIAL
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
/ site restoration if a timely appeal is commenced.
NOTE: The applicant or permitee 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.