HomeMy WebLinkAboutSP-24-08 - Supplemental - 0870 Williston Road (9) 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:
(full names and addresses)
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
See attached list.
870 Williston Road, South Burlington
Adjoining Landowners
AAM Burlington Hotel, LLC c/o AAM 15 Management LLC 78 Blachard Rd, Suite 100 Burlington MA 01803
NAME 1 NAME 2 MAILING ADDRESS 1 CITY STATE ZIP
University of Vermont and State
Agricultural College
c/o UVM Planning Design &
Construction
31 Spear St
Marsh Hall, Suite 10 Burlington VT 05405
State of Vermont Interstate 89 Agency of Transportation 219 North Main Street Barre VT 05641
City of South Burlington 180 Market Street South Burlington VT 05407
89‐2 Realty Co LLC c/o Ellen Greene 19 Farmstead Lane Brookville NY 11545
R L Vallee Inc 280 S Main Street St. Albans VT 05478
DoubleTree Hotel Addition