HomeMy WebLinkAboutZP-18-006 - 0057 Kirby Road 1/5/2018dot, signature verro�auon:
CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
Applicant: �_ l�►d'Z�Yl C�K� Application No: I� I
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Applicant Mailing Address::.C/ W'. 7 / l�r�S A , y I/7y� y
Applicant Email: lihi 4y dGL& dl/i��'! / G Daytime phone: �� 'Z Y-.??z
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Property Owner: NA/14 /J A l—ed Parcel Size:
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Property Owner Mailing Address: i 2 CoAli n Tyr' Tax Parcel ID No. 00 90-0005'I
1. PROPOSED project including building dimensions (describe):
J
/ / /evia
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IN
7
2. Present U,S%E(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): 9
4. Does thhe�e 'project include a proposed change of USE?
[�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):00 ,
6. Building footprint - i.e. size in sq.ft of main floor of house andallattached and detached structures including enclosed
breezeways, garages, and sheds (describe): Existing:_ / Proposed: S &1 1-3-�
7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks)
Existing: J 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)
dodo kgnature ver*'ication:
9. APPLICANT/OWNER CERTIFICATION
The undersigned property owner hereby consents to submit this application and understands that if the application is approved, the
Zonina Permit and any attached conditions will be bindin on the property.
dotloop verified
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Property Owner Signatur PRINT NAME Date
The un rsigne licant hereby affirms that the information presented in this application is true, accurate and complete.
..n� _ant sinnaf_ PRINT NAME Date
DATE Received: '/
Identification of proposed use:
PROPOSED USE TYPE:
EONLY — ADMINISTRATIVE�FFIG%ACTION —OFFICE USE ONLY
9 FEE Re ived: $['1�---.L7y Identification of zoning district:
Date of SITE PLAN approval/denial
Date of SUBDIVISION approval/ denial
Permitted
Conditional
Approval Date Denial Date
Approval Date Denial Date
Date of CONDITIONAL USE approval/ denial
Approval Date
Denial Date
Date of appeal VARIANCE approvall 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
E3/AppROVED
pprova( Date
Permit EFFECTIVE date
FINAL ADMIN
Z 0 N /11
inniistra a Officer's Slignature
®71.1, Permit EXPIRATION date ✓
r
DENIED REASON for DENIAL
Denial Date
Administrative Officer's S►gnature
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 [151 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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