HomeMy WebLinkAboutZP-18-142 - 2071 Williston Road 2 4/24/2018CITY OF SOUTH BURLINGTON
Z O N I N G PERM IT APPLICATION
Applicant:
Applicant Mailing Address:
Applicant Email: i'�'�ZQ'ft)`G/rGEQ%dCf/i�
Property Street Address: %�sL'✓ l �,
Property Owner:
Property Owner Mailing Address:
1. PROPOSED project including building dimensions (des
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�. Present USE(S) of the property:
❑Single family home on its own parcel
El Other (please state the USE per Land Di
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Application No:
ZJ4 0
1 C: L/ - [office use only]
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Daytime phone: �� ,"Z%/S
VT 05403
Parcel Size:
Tax Parcel ID No.
ations- retail, general office, multifamily residential, etc.):
3. List all present structure(s) on property (describe 'nclu in dimensions or square footage of each):
4. Does the project include a proposed change of USE?
❑No (the property will still be used for the same purpose)
QYes (please state proposed changed or add ES per Lan ey�p ent 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:
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. APPLICAN OWNER CERTIFICATION
The u er igned property owner hereby consents to submit this application and understands that if the application is approved, the
Zoni Pe it and any attached cond' ns will be binding on the property.
P operty Owner Signature PRINT NAME Dat
The undersigned applicant hereby affirms that the information presented in this application is true, accurate and complete.
ApplicantSWnature PRINT NAME Date
OFFICE US O Y —ADMINISTRATIVE OFFICER ACTION —OFFICE USE ONLY
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DATE Received: / FEE Received: $ / Identification of zoning district:
Identification of proposed use:
PROPOSED USE TYPE: Permitted Conditional
Date of SITE PLAN approval/denial
Date of SUBDIVISION approval/ denial
Date of CONDITIONAL USE approval/ denial
Date of appeal VARIANCE approval/ denial
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A pro I Date Denial Date
Approval Date
Approval Date
Approval Date
Denial Date
Denial 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 CTION
O N I/9 E T
APPROVED
A proval Da
Permit EFFECTIVE date
DENIED
Denial Date
Ad ini tat- Officer's i ature '%
/e
r Q�((//�� Permit EXPIRATION date /
REASON for DENIAL
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 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.