GRAND ISLE DEVELOPMENT REVIEW BOARD

APPLICATION FOR HEARING

(Submit original and six copies. Original must be completed in blue ink)

Property Code:_____________

Filing Date:________________

Application Number:_________

APPLICANT DATA:

Applicant’s Name(s): ___________________________________________________

Mailing Address:________________________________________________________

Telephone: (Day) _________________________ (Evening) ___________________

Applicant is: Property Owner ______ Lessee____ Prospective Buyer _______

Owner’s Agent __________ (An Agent Form must be completed if checked)

LANDOWNER DATA (If different)

Owner’s Name(s): ____________________________________________________

Mailing Address:________________________________________________________

Telephone: (Day) _________________________ (Evening) ___________________

PROPERTY DATA

Street Address: ___________________________________________________

Tax Map Parcel ID # _________________ Total Acres____________________

Deed filed in Book ______ Page _____ Date recorded ____________________

ADJOINING PROPERTY OWNERS: On the attached sheet, list the names and current mailing addresses of all adjoining property owners, including those across any roads or rights-of-way.

TYPE OF APPLICATION

PLEASE SUBMIT 1 FULL-SIZE AND SIX REDUCED SIZE OF ANY/ALL PLANS

_____ Sketch Plan Review (Attach sketch as described in Section 7.11.1 of the Zoning Bylaw)

_____ Site Plan Review (Attach site plan as described in Section 5.2 of the Zoning Bylaw)

_____ Conditional Use Approval (Attach sketch of the property depicting all relevant details and measurements)

_____ Preliminary Plat Review (Attach maps, drawings and other documents described in Section 7.13.3.3 of the Zoning Bylaw)

_____ Final Plat Review (Attach drawings and other documents described in Section 7.13.2 [Minor Subdivision] or Section 7.13.3.8 [Major Subdivision]

_____ Single Lot Subdivision (Attach map and other documents described in Section 7.13.1.3 of the Zoning Bylaw)

_____ Variance (Attach sketch of the property showing all relevant details and measurements)

_____ Appeal of the Zoning Administrator’s act or decision

_____ Boundary Adjustment (Attach map or drawing)

ZONING DATA

District in which the property is located: _________________________________

Present use of property: _____________________________________________

Proposed use: ____________________________________________________

PROJECT DESCRIPTION (Include elevation sketch of any new construction)

APPEALS

VARIANCE: State the Section(s) of the Bylaw from which you are seeking a variance_______________________________________________

ACT OR DECISION OF THE ZONING ADMINISTRATOR:

Describe the act(s) or decision that you are appealing

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CONDITIONAL USE: Identify the provisions of the Bylaw that apply to your request _______________________________________________________________

If application is for alteration/expansion of a Pre-existing Non-complying structure (Section 4.4), please provide:

Date structure built: ________________ Date lot created: _______________

Applicant’s signature ___________________________________________

EACH PROPERTY OWNER MUST SIGN

Property owner’s signature ______________________________________

MUST BE NOTARIZED

State of Vermont, County of _________________________________

This ________ day of ________________________, 200__, personally appeared _____________________________________________________________________,

To me known to be the person described herein, and who executed the foregoing and acknowledged it to be true to the best of his/her knowledge and belief.

Before me, __________________________________________

Notary Public

My commission expires: ________________

Zoning Administrator: ___________________________________

Date: ________________________________________________

ADJOINING PROPERTY OWNERS

Provide full names and mailing address for each. Attach separate sheet if necessary. Print legibly

Adjoining on North side of subject property:

Adjoining on East side of subject property:

Adjoining on South side of subject property:

Adjoining on West side of subject property: