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HomeMy WebLinkAboutZP-17-433 - 0070 Moss Glen Lane 12/4/2017CITY OF SOUTH BURLINGTON ZONING PERMIT APPLICATION Applicant: Yj r*;gApplication No: �V 7-0&;5 (te� r/aot [office use only] Applicant Mailing Address: � G% ('' ` QQ Applicant Email: if L�l'-. v f� CO"t Daytime phone: Property Street Address: 7-0 en u YA-r110VT 05403 Property Owner: k-s Parcel Size: Property Owner Mailing Address: �� �Tax Parcel ID No. 1. PROPOSED project i13250S,04 ]n-cluding building dimensions (describes): 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): Z o� Z 5-av 51� red- 4. Does the project include a proposed change of USE? >kIVo (the property will still be used for the same purpose) O Yes (please state proposed changed or added USES per Land Development Regulations- retail, general office, multifamily residential, etc.): L5-000, 5. ESTIMATED total cost of improvements (materials and labor): $ 0,C) 6. Building footprint — i.e. size in sq. ft. of main floor of house and all attachpd and detached structures including enclosed breezeways, garages, and sheds (describe): Existing: &—k — Proposed: 7. Total square feet of other impervious surfaces on site (i.e. driveways,os, decks) Existing: Proposed: 8. ATTACH SKETCH PLAN OR SITE PLAN (not required if project consists ONLY of interior renovations or replacement of .fisting roof, siding, etc. in the exact same size) 1 9. APPLICANT/OWNER CERTIFICATION The undersigned property owner hereby consents to submit this application and understands that if the application is approved, the Zoning Permi nd any ttached conditions will be binding on the property. ClikP)n- Vv- Z_ 7 Propg�y OW � Signature PFANT NAME / `� Date Thel��/undersign applicant hereby affirms that the information presented in this application is true, accurate and complete. C���LkA T�, /2 -67?-- 1 7- Aimlicafft Siona re P INT NAME Date OX// SE 0 LY — ADMINISTRATIVE OFFICER ACTION — OFFICE USE ONLY DATE Received: ( FEE Received: $ T Identification of zoning district: Identification of proposed use: PROPOSED USE TYPE: Date of SITE PLAN approval/denial Date of SUBDIVISION approval/ denial Date of CONDITIONAL USE approval/ denial Date of appeal VARIANCE approval/ denial Permitted Approval Date Approval Date Approval Date Approval Date Conditional Denial 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 or12Not Applicable 'APPROVED Permit EFFECTIVE date / DENIED Denial Date FINAL ADMINISTRATIVE OFFICER ACTION O N er's nature O 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 remov I 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.