HomeMy WebLinkAboutSP-23-040 - Supplemental - 1068 Williston Road (3)
575 Dorset Street South Burlington, VT 05403 tel 802.846.4106 fax 802.846.4101 www.sburl.com
Application Number SP-______-__________ (office use only) APPLICATION FOR SITE PLAN REVIEW (City Center FBC District)
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.
1. Street Address of Project: _________________________________________________________________
2. Brief project description (explain what you want approval for):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Applicant
Name __________________________________
Address________________________________
_______________________________________
Email _____________________________________
Telephone_________________________________
4. Primary Contact (person who will receive all correspondence from Staff)
Name __________________________________
Address________________________________
_______________________________________
Email _____________________________________
Telephone_________________________________
5. Owner(s) of Record (Name(s) as shown on deed, mailing address, phone and fax #):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
6. Project Summary
a. Existing Uses on Property (including description and size of each separate use):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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b. Proposed Uses on property (include description and size of each new use and existing uses to remain):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
c. Building size (GFA) Existing _______________ Proposed _______________
d. Residential Units Existing _______________ Proposed _______________
e. Does this project require meeting Section 18.01, Inclusionary Zoning? Yes No
If yes to above, please indicate below the number of dwelling units that will be reserved in perpetuity
for households in each income category. Please see 18.01(C) for the proportion that must be devoted to
each income category and how to calculate fractional dwelling units.
Affordable Units #s 80% of Median _______ 100% of Median _______ 120% of Median _______
f. Qualifying open space (SF) Existing _______________ Proposed _______________
7. Project Details.
a. Completed Submission checklist □
b. Completed BES checklist & self-evaluation □
c. Supporting documents and narrative for certain circumstances (including but not limited to):
i. Section 8.06, Special Standards; Section 8.07 Materials; Section 8.08 Open Space Standards;
Section 8.09 Nonconformities
ii. Article 10, Overlay Districts
iii. Article 12, Surface Water Protection Standards
iv. Article 13, Supplemental Requirements
8. Total Parcel Size (sq. ft.) ______________ Total Impervious coverage (sq. ft.) ______________
9. 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
and Stormwater Management in Article 12 of the Land Development Regulations. Projects disturbing more than one acre require a permit from the Vermont Department of Environmental Conservation.
10. Cost Estimates.
a. Building (including interior renovations). $____________________
b. Landscaping: $____________________
c. Other site improvements (please list with cost): ____________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
10. Traffic / Trip Generation.
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a. Land Use Code(s) Used, Independent Variables, Calculations
___________________________________________________________________________
___________________________________________________________________________
b. P.M. Peak hour for entire property (In and out):____________________________________
11. Estimated Project Completion Date. ______________________________________________
12. 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.
13. List of Project Sheets. Include a list of each project sheet submitted by number.
14. Notification of Adjoining Property Owners, Neighborhood Meeting. Notification of adjoining property
owners is the responsibility of the applicant. After determining that all submission requirements have been met,
the Administrative Officer will provide the applicant with a project description and sample certificate of service.
The sworn certificate of service shall be returned to the City along with demonstration of having met all of the
requirements of Section 14.05 of the Land Development Regulations.
a. Proposed location of neighborhood meeting (if applicable): _____________________________________
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.
_____________________________ _____________________________ _____________
Applicant’s Signature Applicant’s Printed Name Date
_____________________________ _____________________________ _____________
Property Owner’s Signature Property Owner’s Printed Name Date
___________________________________________________________________________
Do not write below this line
Date of Submission: __________________________________
Review Authority: Development Review Board Administrative Officer
Action: 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.