HomeMy WebLinkAboutZP-17-430 - 0002 Adirondack Street 12/1/2017CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
Applicant: �(� ✓��1� - l�e�i I " l cC�
Applicant Mailing Address: a- ��Vt ✓(/VICE �j
Applicant Email:
Application No:
Daytime phone2502-4(Q)-- 0(0-i- l
Property Street Address: �'TA,t ✓�'l�Glt_f!,l ►`�,n VT 05403
Property Owner: Y� -�-2 2 /'a 2-�-142ar el (Size:
Property Owner Mailing Address: �? Avet �Cytjacit- 'SL ���"TTaX Pa� el ID No.
1. PROPOSED project including building dimensions (describe):
2. Pr, ,,'-it USE(S) of the property:
Single family home on its own parcel
O 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):
FM
4. Does the project include a proposed change of USE?
P No (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.):
5. ESTIMATED total cost of improvements (materials and labor): $ 64 bO
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:
7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks)
Proposed:
Existing: Proposed:
8. 4TTACH SKETCH PLAN OR SITE PLAN (not required if project consists ONLY of interior renovations or replacement of
)isting 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 Permit and any attached conditions will be binding on the property.
Property Owner Signature
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 IC USEONLY —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 o ISCELLANEOUS approval/ denial
Approval Date
Denial Date
Provided applicant copy of URBEC or VCBE
Standards Handbook or❑Not Applicable
APPROVED
Approval Date
Permit EFFECTIVE date
DENIED
Denial Date
FINAL ADMINISTRATIVE OFFICER ACTION
ZO N"A2 /P)I%T
Officer'steignature / / /�
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. fr
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.