HomeMy WebLinkAboutSD-24-05 - Supplemental - 0252 Autumn Hill Road (2) South Burlington Sample Certificate of Service Form. Rev. 3-2022
CITY OF SOUTH BURLINGTON CERTIFICATE OF SERVICE
I hereby certify that on this ______ day of ________, 20___, a copy of the foregoing public
notice for _________________[type of application] #___________ [application number], was
sent by U.S. mail, postage prepaid to the owners of all properties adjoining the subject property
to development, without regard to any public right-of-way, and including the description of the
property and accompanying information provided by the City of South Burlington. I further
certify that this notification was provided to the following parties in accordance with 24 V.S.A.
§4464(a) and Section 17.06(B) of the South Burlington Land Development Regulations:
List of recipients:
City of South Burlington575 Dorset StreetSouth Burlington, VT 05403
Somdeb & Shreya Chatterjee165 Windswept LaneSouth Burlington, VT 05403
Tika & Sital Dulal253 Autumn Hill Road South Burlington, VT 05403
Charles Scott & Judith Tust107 Wild Rose Lane St George, VT 05407
Highland Crossing Homeowners Association, Inc.141 Windswept Lane South Burlington, VT 05403
Dorset Farms Homeowners Association, Inc.183 Catkin DriveSouth Burlington, VT 05403
Timothy Kavanaugh & Candy W Trust 26 Weeping Willow Lane South Burlington, VT 05403
Dated at __________[town/city], Vermont, this _________ day of ___________, 20_____.
Printed Name:_______________________________________________
Phone number and email: _______________________________________________
Signature:_______________________________________________
Date:_______________________________________________
Remit to: City of South Burlington
Department of Planning & Zoning
180 Market Street
South Burlington, VT 05403