HomeMy WebLinkAboutSD-23-04 - Supplemental - 1185 1195 Shelburne Road (6)
575 Dorset Street South Burlington, VT 05403 tel 802.846.4106 fax 802.846.4101 www.sburl.com
Permit Number SD-______-__________
(office use only) APPLICATION FOR SUBDIVISION SKETCH 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 rejected and a
delay in the review before the Development Review Board. For amendments, please provide pertinent
information only.
1) OWNER(S) OF RECORD (Name(s) as shown on deed, mailing address, phone and fax#)
2) LOCATION OF LAST RECORDED DEED(S) (Book and page #)
3) APPLICANT (Name, mailing address, and phone #)
4) APPLICANT’S LEGAL INTEREST IN THE PROPERTY (fee simple, option, etc.)
5) CONTACT PERSON (Name, mailing address, and phone #)
5a) CONTACT EMAIL ADDRESS
6) PROJECT STREET ADDRESS
7) TAX PARCEL ID # (can be obtained at Assessor’s Office)
8) PROJECT DESCRIPTION
a) General project description (explain what you want approval for):
2 Sketch Plan Application Form. Rev. 01-2020
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) Proposed height of building (if applicable)
f) Number of residential units (if applicable, new units and existing units to remain)
g) Other (list any other information pertinent to this application not specifically requested above, please note
if Overlay Districts are applicable)
9) LOT COVERAGE
a) Building: Existing % Proposed %
b) Overall (building, parking, outside storage, etc)
Existing % Proposed %
c) Front yard (along each street) Existing % Proposed %
10) TYPE OF EXISTING OR PROPOSED ENCUMBRANCES ON PROPERTY (easements, covenants, leases, rights of
way, etc.)
11) PROPOSED EXTENSION, RELOCATION, OR MODIFICATION OF MUNICIPAL FACILITIES (sanitary sewer, water
supply, streets, storm drainage, etc.)
12) ESTIMATED PROJECT COMPLETION DATE