Non-Applicability Of Zoning Permit Requirements - Department Of Planning And Zoning printable pdf download

Department of Planning and Zoning

149 Church Street, City Hall

Burlington, VT 05401-8415

Phone: (802) 865-7188

Fax: (802) 865-7195

Non-Applicability of Zoning Permit Requirements

This form is a written verification from the Department of Planning and Zoning that based upon the description and statement

given by the owner/applicant, a zoning permit is not applicable or required for the proposed project.

Please submit this form, with photograph(s) of the area(s) where work is proposed, to the Planning and Zoning Office.

NOTE: THIS IS NOT AN APPROVAL TO START WORK.

CONSTRUCTION PERMITS WILL ALSO BE REQUIRED FROM THE DEPARTMENT OF PUBLIC

WORKS AT 645 PINE STREET. VISIT THE OFFICE OR CALL 802-863-9094

PROJECT LOCATION ADDRESS: ____________________________________________________

PROPERTY

APPLICANT :_____________________________

OWNER*:________________________________

*If condominium unit, written approval from the Association is also required

POSTAL ADDRESS: _______________________ POSTAL ADDRESS: _______________________

CITY, ST, ZIP: ____________________________

DAY PHONE: _____________________________ DAY PHONE: ____________________________

EMAIL: __________________________________ EMAIL: __________________________________

SIGNATURE: _____________________________

SIGNATURE: ____________________________

I am the owner. In addition, I duly authorize the applicant (if noted)

to act on my behalf for all matters pertaining to this application.

Description of Proposed Project: ______________________________________________________

__________________________________________________________________________________

 Single Family

 Multi Family: __ Units

Other:_____________

Existing Use of Property:

Proposed Use of Property:  Single Family

 Multi Family: __ Units

Other:_____________

OFFICE USE ONLY

Zone: _____ Eligible for Design Review? ____ Year Constructed? _____ Property Size? _________

Based upon the above description, the proposed work does not require a zoning permit for the

following reason(s):

 Project constitutes repair/maintenance or replacement in-kind.

 Project is exempt from Zoning Permit requirements per Section 3.1.2(c)1 of the Zoning Ordinance.

 Other: __________________________________________________________________________

Reviewed and approved by: ___________________________________ Date: ________________

 Additional Notes: __________________________________________________________________

__________________________________________________________________

Non Applicability Reference #: _____________________

October 2014

Non-Applicability Of Zoning Permit Requirements - Department Of Planning And Zoning

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