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Property Code:
Combined Permit Application
To expedite your application, please read the following instructions carefully. Incomplete applications will delay the review and may
cause the application to be denied. All pages must be returned.
This application is required for any exterior work or interior modifications to your property. This form will be used to apply for any
work within the City of Winooski related to building, zoning, or public infrastructure. Please read the following information carefully as
you fill out all the information listed in this application. Failure to complete all the required information in this application will result in
delays of review and possible denial of the request. State permits may also be required.
Applicants are responsible for contacting the Vermont Division of Fire Safety; Williston Department to coordinate State of Vermont Permitting:
802 879 2300
Energy Efficiency Standards may also apply as identified by Efficiency Vermont: 888 921 5990
Section 6.10 of the City’s Unified Land Use and Development Regulations require this application be submitted to the City and include
any application fees as may be established by the City Council. In addition to any required fees, the application shall also include the
A statement describing the existing and intended use of the land and structures and/or any proposed structural changes.
A sketch plan, no smaller than 8.5” x 11”, drawn to scale, and accurately depicting:
the dimensions of the lot, including existing and proposed boundaries
the location, footprint, and height of existing and proposed structures, and additions
the location and dimension of existing and proposed accesses (curb cuts), driveways, and parking areas
the location of existing and proposed easements, rights-of-way, and utilities
setbacks from property boundaries, road rights-of-way, surface waters, and wetlands
the location of existing and proposed water and wastewater connections
other information as may be needed to determine compliance with these regulations as specified
by the Zoning Administrator
Please contact the Planning and Zoning Manager to schedule a meeting or discuss details/fees prior to applying (this will assist in
determining the level of detail needed and may expedite processing). Depending on specifics and scale of project, not all of the items
listed above may be applicable and additional information may be required (including review by another board or commission for
conditional use, etc.).
I have read and acknowledge the requirements necessary to submit this application. I understand that failure to provide
the required items listed above and, in this application, may result in a denial of my application. I understand that any fees
paid with this application are non-refundable regardless of approval or denial of this application. By signing this application, I
grant the City of Winooski or their representatives’ permission to access the property identified in this application for the
purposes of reviewing and verifying conditions are as represented and hold the City harmless for any impacts to the property.
Applicant’s Signature ________________________________ Date _________________
Property Owner's Signature ________________________________ Date _________________
(If different from applicant)
click to sign
click to edit
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Property Code:
Applicant Information [ ] Check here if primary contact
Name Street Address
Primary Phone Number City
Primary email State Zip Code
Owner Information (if different from applicant) [ ] Check here if primary contact
Name Street Address
Primary Phone Number City
Primary email State Zip Code
Description of Work to be Completed
Include extra pages if necessary
Property Address
Description of Work
Check all that apply:
* = state permits may be required
Multi-Departmental Permits
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Building Permits
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Zoning Permits
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For Official Use Only
Application Received by:
Zoning Permit #
Fee Paid
Building Permit #
Property Code:
Building Permit Fee
Site Plan Attached
Owner Signature
Application Fee
Project Narrative
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The area below can be used to draw simple site plans that show property boundaries, existing structures, proposed structures, or proposed
conditions. Include dimensional measurements for any features identified and setbacks from property boundaries. If the project area is larger or
more complex than what can be accommodated below, additional drawings prepared by a design professional should be provided.
Scale: 1 square = ____ ft.
Applicant Checklist
Applications will not be accepted without the following actions included:
Sign the Application Include a description of the work
Include a site plan Identify the type of permit
Pay your application fee Provide site photos, renderings, or any other information
(complete fee schedule on page 4) (required for sign permits)
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Fees and Instructions
Complete the following fee worksheet as it relates to the specific work you have proposed in this application package (listing the total amount of
all fees is required upon submission). Calculations will be evaluated to ensure that the appropriate funds have been submitted. Errors resulting in
over or under payment will be corrected when permits are issued. Additional fees may be required depending on the project/development’s
specifications. If the proposed work is not identified below, contact the Planning and Zoning Manager: 802 655 6410 (consult Chapter 28 of the
City’s Municipal Code). The Grand Total amount will be due upon submission of this application. Failure to include the appropriate fees will
result in an incomplete application.
The fees Identified below represent zoning permits only. Additional fees may be required for building permits or public works permits. Fees for
building permits and public works permits will be calculated at the time of issuance. The estimated cost of work will be used to evaluate to
appropriate fees as outlined In Chapter 28 of the City's Municipal Code.
Estimated Cost of Work $_______________________
Zoning Permit Fees
Complete either the left side or the right side of the fee chart, BUT NOT BOTH. If the proposed work is referenced under the
Specific Project” heading, complete the left side only. If the proposed work is referenced under the “Generalheading complete
the right side only. Projects that require approval from the Development Review Board (DRB), such as subdivisions, planned
unit developments, site plan review, conditional uses, waivers, or variances will require additional fees. Consult the Zoning
Administrator prior to submission of application.
Specific Project Zoning Permits - $100.00
New Construction
Building Additions
Residential - Single Family & Duplex
____________square feet x $0.10 = $______________
_____________square feet x $0.12 = $_____________
_____________square feet x $0.15 = $_____________
Gateway/Mixed Use
_____________square feet x $0.25 = $_____________
Specific Zoning Project Permit Total
$_________________________________ + Recording Fee
(square footage fee plus base fee)
General Zoning Permits - $75.00
Change of Use
Sign(s) (New)
Swimming Pool
Deck/Patio (No other changes)
Accessory Structure (No other changes)
PLUS: Recording Fee
1. Recording fees will be set based on state guidelines. Current
recording fees are $15.00.
2. From one permitted use to another permitted use in an existing
Grand Total (zoning permit and recording fees) $____________________________