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City of South Burlington
Application to Board of Adjustment
Official Use
APPLICATION #
Date /�/= s/
Applicant &;&p ?.c9 Ix -
Own r, leasee, agent
HEARING DATE
FILING DATE
FEE AMOUNT
Address 11A.3 922EI: 09-1K Telephone # _,may
Landowner / �/�R,9 I—A/i ��9E�"j<Z!-- 0 Address j/O. 5, c�✓�L
Location and description of property //o`3 2Zz-2/;0,77- 4 /Z
Type of application check one ( ) appeal from decision of Administrative
Officer( )request for a conditional use ( 4/j request for a variance.
I understand the presentation procedures required by State Law (Section
4468 of the Planning & Development Act). Also that hearings are held twice a
month (second and fourth Mondays). That a legal advertisement must appeal
a minimum of fifteen (15) days prior to the hearing. I agree to pay a
hearing fee which is to off -set the cost of the hearing.
Provisions of zoning ordinance in question j--o ' Td
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Reason for appeal V � 1 �/�,�t'���5',cJ�E �-o d:c,ry ARO f�e,5RB
The owner or applicant should submit along with this application (8 copies)
plans, elevations, landscaping diagrams (drawn to scale) traffic data and
any other additional information which will serve as support evidence to the
Board.
eari g Date Signa e f Appellant
Do not write below this line
SOUTH BURLINGTON ZONING NOTICE
In accordance with the South Burlington Zoning Regulations and Chapter 117,
Title 24, V.S.A. the South Burlington Zoning Board of Adjustment will hold
a public hearing at the South Burlington Municipal Offices, gonference Room,
575 Dorset Street, South Burlington, Vermont on '
Day of Week
at ?�� "''" to consider the following:
M th and Date Time
Appeal of
seeking a from Section od-lk-" te,:-,
of the S utth- Burlington Regulations. Request is
for pe-r-miission to
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