HomeMy WebLinkAboutSD-23-15 Sketch Plan - Supplemental - 0850 Hinesburg Road (10)
180 Market Street South Burlington, VT 05403 tel 802.846.4106 fax 802.846.4101 www.sburl.com
Application 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. PROJECT STREET ADDRESS:
2. OWNER(S) OF RECORD (Name(s) as shown on deed, mailing address, phone)
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:
6. TAX PARCEL ID # (can be obtained at Assessor’s Office):
7. PROJECT DESCRIPTION
a. General project description (explain what you want approval for):
b. Existing Uses on Property (including description and size of each separate use):
2 Sketch Plan Application Form. Rev. 01-2020
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. Other (list any other information pertinent to this application not specifically requested above, please
note if Overlay Districts are applicable):
8. LOT COVERAGE (ALL information MUST be provided. For Planned Unit Developments involving multiple
parcels, attach additional sheets)
Total Parcel Size: acres / 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.
9. NATURAL RESOURCE INFORMATION
a. Are there any Natural Resources (as defined in the Land Development Regulations Article 12) on the
subject property?
4 Sketch Plan Application Form. Rev. 01-2020
I have reviewed this site plan application and have taken the following action:
Date of Complete Application:
Date Referred to Development Review Board:
________________________________________________________
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.