CERTIFICATE OF OCCUPANCY
APPLICATION
For informaon contact the Zoning Administrave Ocer at 434-2430.
Other federal, state and local permits or approvals may addionally be required, the applicant retains
the duty to obtain all relevant and applicable approvals. To inquire about State permits contact the State
Permit Specialist at 802-477-2241.
Parcel ID: _____________
Fee: $15.00 + RBES/CBES
Recording Fee (if applicable)
Applicaon Date: ______________ Physical Address of Property: _____________________________________________________
Applicant Name: ______________________________________
Applicant Mailing Address: ______________________________
____________________________________________________
____________________________________________________
Phone: ______________________________________________
Email: _______________________________________________
Property Owner Name: _________________________________
Owner Mailing Address: ________________________________
____________________________________________________
____________________________________________________
Phone: ______________________________________________
Email: _______________________________________________
The purpose of this permit request is to cerfy that the structure or use at the above locaon conforms to the approved plans led
with the Zoning Administrave Ocer for the zoning permit referenced below and with all applicable provisions of the Richmond
Zoning Regulaons. No construcon may be commenced or change of use made which is inconsistent with this permit.
Cercate of Occupancy Requested for the following Permits (include zoning permit numbers of previously approved permits, the
permit number can be found on the top right-hand side of permit applicaon form):_______________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
If the CO is a requirement for a property closing please indicate closing date: ____________________________________________
As per VSA 24 secon 4449, for building projects (including new construcon, addions, alteraons, renovaons or repairs to an
exisng building) a cercate shall be presented to the Zoning Administrave Ocer cerfying the building has been constructed
in compliance with the requirements of the residenal building energy standards (RBES) or the commercial building energy stand-
ards (CBES). A copy of the cercate shall also be recorded in the land records. An addional $15 per page recording fee shall be
charged for the recording of this documents.
TOWN CLERK’S OFFICE Received for Record: __ _______ A.D. At __o’clock _ _ minutes _ M
And Recorded in Book: page Aest:
—- DO NOT WRITE BELOW THIS LINE—OFFICE USE ONLY—DO NOT WRITE BELOW THIS LINE—OFFICE USE ONLY—DO NOT WRITE BELOW THIS LINE—OFFICE USE ONLY —-
Applicaon Complete Date: Decision: APPROVED / DENIED / WITHDRAWN Recording Fee: _____________
Comments: ________
________ _______
________ _______
Zoning Administrave Ocer signature: Date:
Signatures: The undersigned hereby ceres this informaon to be complete and true.
Applicant Signature Date Property Owner Signature Date
Applicaon created July 2017
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