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HomeMy WebLinkAboutSP-23-007 - Supplemental - 0650 Spear Street 575 Dorset Street South Burlington, VT 05403 tel 802.846.4106 fax 802.846.4101 www.sburl.com Permit Number SP-______-__________ (office use only) APPLICATION FOR SITE PLAN REVIEW □ Administrative □ Development Review Board 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 site plan will result in your application being rejected and a delay in the review before the Development Review Board. 1. OWNER(S) OF RECORD (Name(s) as shown on deed, mailing address, and phone): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 2. LOCATION OF LAST RECORDED DEED(S) (Book and page #): __________________ 3. APPLICANT (Name, mailing address, phone): ___________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 4. CONTACT PERSON (person who will receive all correspondence from Staff. Include name, address, phone):____________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 4a. CONTACT EMAIL ADDRESS: _________________________________________________________ 5. PROJECT STREET ADDRESS: _________________________________________________________________ 6. TAX PARCEL ID # (can be obtained at Assessor’s Office): __________________________________________ 7. PROJECT DESCRIPTION a. General project description (explain what you want approval for): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 2 Site Plan Application Form. Rev. 5-2018 __________________________________________________________________________________________ b. Existing Uses on Property (including description and size of each separate use): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ c. Proposed Uses on property (include description and size of each new use and existing uses to remain): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ d. Total building square footage on property (proposed buildings and existing buildings to remain): __________________________________________________________________________________________ __________________________________________________________________________________________ e. Height of building & number of floors (proposed buildings and existing buildings to remain, specify if basement and mezzanine): ____________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ f. Number of residential units (if applicable, new units and existing units to remain): __________________________________________________________________________________________ g. Number of employees (existing and proposed, note office versus non-office employees): __________________________________________________________________________________________ __________________________________________________________________________________________ h. Other (list any other information pertinent to this application not specifically requested above, please note if Overlay Districts are applicable): ______________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 3 Site Plan Application Form. Rev. 5-2018 8. LOT COVERAGE Total Parcel Size: _____________Sq. Ft. a. Building: Existing ________ % / _____________sq. ft. Proposed _________% / _____________sq. ft. b. Overall impervious coverage (building, parking, outside storage, etc) Existing ________% / _____________sq. ft. Proposed ________% / _____________sq. ft. c. Front setback non-building coverage (along each street, commercial properties only) Existing ________% / _____________sq. ft. Proposed ________% / _____________sq. ft. d. Total area to be disturbed during construction (sq. ft.) ______________* * Projects disturbing more than one-half acre of land must follow the City’s specifications for erosion control in Article 16 of the Land Development Regulations. Projects disturbing more than one acre require a permit from the Vermont Department of Environmental Conservation. 9. COST ESTIMATES a. New Building or Addition, including initial fit-up (if initial fit-up cost not available, contact Planning & Zoning staff): $ ____________________ b. Landscaping: $____________________ c. Other site improvements (please list with cost): _______________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 10. ESTIMATED TRAFFIC a. P.M. Peak hour for entire property (In and out):____________________________________ 11. PEAK HOURS OF OPERATION: _________________________________________________ 12. PEAK DAYS OF OPERATION: __________________________________________________ 13. ESTIMATED PROJECT COMPLETION DATE: ______________________________________ 14. SITE PLAN AND FEE A site plan shall be submitted which shows the information required by the City’s Land Development Regulations. Three (3) regular size copies, one reduced copy (11" x 17"), and one digital (PDF- format) copy of the site plan must be submitted. A site plan application fee shall be paid to the City at the time of submitting the site plan application in accordance with the city’s fee schedule. 4 Site Plan Application Form. Rev. 5-2018 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 requested as part of this application has been submitted and is accurate to the best of my knowledge. ________________________________________ SIGNATURE OF APPLICANT ________________________________________________________________________ SIGNATURE OF PROPERTY OWNER PRINT NAME ___________________________________________________________________________ Do not write below this line DATE OF SUBMISSION: __________________________________ REVIEW AUTHORITY:  Development Review Board  Administrative Officer I have reviewed this site plan 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.