HomeMy WebLinkAboutMP-22-01 - Supplemental - 0255 Kennedy Drive (4)
575 Dorset Street South Burlington, VT 05403 tel 802.846.4106 fax 802.846.4101 www.sburl.com
Permit Number MP-______-__________
(office use only) APPLICATION FOR MASTER PLAN REVIEW
All information requested on this application must be completed in full. Failure to provide the requested
information either on this application form or on the plans will result in your application being deemed
incomplete, and a delay in scheduling for the Development Review Board.
1) OWNER OF RECORD (Name as shown on deed, mailing address, and phone)
2) LOCATION OF LAST RECORDED DEED (Book and page #)
3) APPLICANT (Name, mailing address, phone, and e-mail)
4) APPLICANT’S LEGAL INTEREST IN PROPERTY (i.e. fee simple, option, etc.)
5) CONTACT PERSON (Name, mailing address, phone, and e-mail
5a) CONTACT EMAIL ADDRESS:
6) PROJECT STREET ADDRESS:
7) TAX PARCEL ID # (may be obtained online or at the Assessor’s Office):
8) PROJECT DESCRIPTION:
a) General project description (explain what you want approval for):
b) Existing uses on property (please describe sizes of each separate use, if applicable)
2 Master Plan Application Form. Rev. 01-2020
c) Proposed uses on property (please describe the size or number of units and nature of proposed uses)
d) Maximum total number of residential units and/or square footage of uses to be developed, including any
existing units and/or uses to remain:
e) Maximum proposed building height (if applicable)
f) Proposed phasing (please describe the number of total phases and, if applicable at this time, the number of
units or square feet of uses to be proposed in the first phase):
9) MASTER PLAN UMBRELLA CRITERIA
a) Total acreage of involved property(ies)
b) Total acreage of first phase for development (if known at this time)
c) Total number of residential units and/or sq ft of all uses requested
d) Existing impervious coverage, entire site (sq ft and %):
e) Maximum proposed impervious coverage, entire site (sq ft and %):
f) Maximum existing building coverage, entire site (sq ft and %) :
g) Maximum proposed building coverage, entire site (sq ft and %):
h) Estimated number of existing PM peak hour vehicle trip ends:
i) Maximum proposed number of PM peak house vehicle trip ends:
j) Existing or proposed encumbrances on property (easements, covenants, leases, rights of way, etc.)
3 Master Plan Application Form. Rev. 01-2020
k) Proposed extension, relocation or modification of municipal facilities (sanitary, sewer, water supply, streets,
stormwater, etc.) – please describe briefly
10) ESTIMATED FINAL PROJECT COMPLETION YEAR
11) PLANS AND FEE
Plans shall be submitted which show the information required by the City’s Land Development Regulations. One
digital (PDF format) copy of all application materials listed in LDR Appendix E, with plans provided as individual
sheets and named to include sheet number and latest revision date, must be submitted. An application fee shall
be paid to the City at the time of submitting the application in accordance with the City’s fee schedule.
NOTE: NOTIFICATION of ADJOINING PROPERTY OWNERS: Notification of adjoining property owners, in
accordance with 24 V.S.A. §4464(a) and Section 17.06(B) of the South Burlington Land Development
Regulations, is the responsibility of the applicant. After deeming an application complete, the Administrative
Officer will provide the applicant with a draft meeting agendas or public hearing notice and sample certificate of
service. The sworn certificate of service shall be returned to the City prior to the start of any public hearing.
I hereby certify that all the information request as part of this application has been submitted and is accurate to
the best of my knowledge.
_________________________________ ______________________________
Signature of Applicant Signature of Property Owner
____________________________________________________________________________________
Please do not write below this line
DATE OF SUBMISSION _________________________________
I have reviewed this application and find it to be:
COMPLETE INCOMPLETE
______________________________________________ _________________
Administrative Officer Date
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.