HomeMy WebLinkAboutZP-17-428 - 1212 Williston Road 11/29/2017CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
Applicant:
Applicant Mailing Address: �( J—t�"D (-F-trif_ -Pr'
Application No:
% 1 r use
Applicant Email: 4' d'f �i I. C 0 rrt r�c1l `'�V a`L S e &Jt Daytime phone: 80d_3 j L f C
Property Street Address: �d�-�r� �� % L l / S 4 �0 uy (_I , , VT 05403
Property Owner: G - CJ' Parcel Size:n_ '_� _Sq
Property Owner Mailing Address:_ L0_'1 % rv,. L- l f . Tax Parcel ID No. 19 jd ` 134
1. PROPOSED project including building dimensions (describe): /&.%o 5�` f-1- --t- or —
P22m �,Z�ar-Ctu•,-t- _AQ G !z-A-) f_r-a ( 01,11 cs
Present USE(S) of the property:
❑ Single family home on its own parcel
il9ther (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?
❑No (the property will still be used for the same purpose)
ARYes (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): $
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: 5/50yif-
7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks)
Existing:
Proposed: _�Ac
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)
1
9. APPLICANT/OWNER CERTIFICATION
The undersigned property owner hereby consents to submit this application and understands that if the application is approved, t,
Zoning Permit and any attached conditions will be binding on the property.
Property Own Signature MINT NAME Date
The undersigned applicant hereby affirms that the information presented in this application is true, accurate and complete.
Applicant Sig ature PRINT NAME Date
O FICE USE ONLY — ADMINISTRATIVE OFFICER ACTION — OFFICE USE ONLY
DATE Received: FEE Received: $ Identification of zoning district:
Identification of proposed use: �/
PROPOSED USE TYPE: PermittedConditional
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 of MISCELLANEOUS approval/ denial
Approval Date
Denial Date
❑ Provided applicant copy of URBEC or VCBE Standards Handbook or[2Not Applicable
APPROVED l 1 /�
App oval Dat4
Permit EFFECTIVE date
1-1 DENIED
Denial Date
FINAL ADMINISTRATIVE OFFICER ACTION
� Z O N I N E T,
/ Admi istrative Officer's Sig ature
/\ 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.