Town of Milton, VT | Zoning Permit Application | Page 1 of 4 | Last Revised September 3, 2019
TOWN OF MILTON, VT | ZONING PERMIT APPLICATION
If you have any questions, call (802)893-1186 or visit us in the Milton Municipal Complex at 43 Bombardier Road, Milton, VT 05468.
FILING INFORMATION (STAFF USE ONLY)
Zoning Permit # ___ ___ ___ ___ - ___ ___ ___
Filing Date ___ ___ /___ ___ /___ ___
Expedited Review Due ___ ___ /___ ___ /___ ___
PERMIT USE CATEGORY(check box that applies)
Residential
Non-Residential
Mixed-Use
(both)
PROPERTY INFORMATION
Street Address/Unit:
Parcel ID:
__ __ __ __ __ __ . __ __ __ __ __ __
School Parcel Account # 396 - 123 - __ __ __ __ __
Deed: Volume no. __ __ __ / Page no. __ __ __
Zoning District: Lot Size (acres):
Road Frontage (feet):
Existing Principal Use Definition (e.g. "single family dwelling")
PERMIT TYPE (check all boxes that apply)
New Principal Building or Unit (ex. "single-family dwelling")
New Accessory Structure
(ex. shed)
Alteration to Existing Structure
(ex. new room addition)
Change of Use
(ex. "personal service" to "restaurant")
Demolition/Removal (ex. demolition & removal of pool)
Sign (one-sided square footage equals ___________s.f.)
Amendment to Prior Permit
# __ __ __ __ - __ __ __
Renewal of Prior Permit # __ __ __ __ - __ __ __
Other (ex. home occupation, lot line adjustment)
LANDOWNER
Name(s)
Name(s)
Mailing Address
City State Zip Code
Phone
Email
APPLICANT check box if same as landowner
Name(s)
Name(s)
Mailing Address
City State Zip Code
Phone
Email
LAND DEVELOPMENT (PROJECT) INFORMATION
Proposed Principal Use Definition (if changing): Approximate Value of Development: $
Total New Finished Floor Area
(sq. ft.): Maximum Height (ft.):
Total New Unfinished Floor Area (sq. ft.): Number of Stories:
Is this project in a Tax Increment Financing (TIF) District? Yes No
If yes, check which district: North/South or Town Core, and list how many jobs will this project create________________.
Description of Land Development (briefly describe the project with dimensions):
ADDITIONAL PERMITTING (please answer to determine if additional permitting/action is required for your project)
1. Has this project undergone prerequisite development review? Yes No
If yes, provide the case description(s) & approval date(s): *Your project will be subject to all conditions of the approval.
2. Does the project involve work within a Town or State right of way? Yes No
If yes, please provide permit # and approval date(s): You must obtain Highway Access
permit approval from the Department of Public Works at (802) 893-6030 and/or Vermont Agency of Transportation at
(802) 279-1152 prior to receiving an approved zoning permit.
3. Does the project involve connecting to municipal water or sewer? Yes No
If yes, please provide permit # and approval date(s): You must obtain approval from Public
Works and/or the State Water/Wastewater Division prior to construction.
4. Does the project involve a change of the number of bedrooms or a change of use? Yes No
If yes, contact the State Water/Wastewater Division at (802) 879-5656 and provide permit # or determination with this application.
5. Is your project subject to the Residential/Commercial Building Energy Standards? Yes No
If yes, you must record a Vermont Residential/Commercial Energy Standards (RBES or CBES) Certificate in the Land Records prior to receiving
your Certificate of Compliance/Occupancy. Contact Energy Code Assistance Center at (855) 887-0673 or online at
http://publicservice.vermont.gov/topics/energy_efficiency/rbes to determine if you need to follow these standards.
6. Does your project involve any demolition and/or renovation? Yes No
If yes, you must contact the Lead and Asbestos Regulatory Program at (800) 439-8550 prior to demo/renovation.
7. Does your project involve any disturbance of soil? Yes No
If yes, you must follow requirements of Section 3009 Erosion Control and Section 3010 Stormwater Management of the UDR Bylaws.
For further guidance, see the VT ANR’s Low Risk Site Handbook for Erosion Prevention and Sediment Control.
8. Does your project involve the installation of a new manufactured home? Yes No
If yes, you must provide a copy of the HUD Form 309 with the Certificate of Compliance/Occupancy Application.
Town of Milton, Vermont Zoning Permit Application, Page 2 of 4, Last Revised September 3, 2019
Zoning Permit # ___ ___ ___ ___ - ___ ___ ___ (STAFF USE ONLY)
SITE DRAWING OF THE PROPERTY
Draw an aerial view of the property described above showing the actual shape, property lines, dimensions of land; shape, size and location of
all existing and proposed structures (principal and accessory) on the property with measurements to the front, side and rear property boundary
lines (setbacks) and distances between each structure; the existing and intended uses and areas of use of the land and all buildings, and
location of septic/sewer and water utilities. Label unit numbers if applicable. If this application includes a SIGN, also draw a side elevation of
the sign with content. If this application is for a project that has undergone DEVELOPMENT REVIEW approval, write "see final plans of
record" or attach a copy of the plans of record deemed final by staff.
Town of Milton, Vermont Zoning Permit Application, Page 3 of 4, Last Revised September 3, 2019
Zoning Permit # ___ ___ ___ ___ - ___ ___ ___ (STAFF USE ONLY)
LANDOWNER & APPLICANT ACKNOWLEDGEMENTS
By signing this form, the landowner(s) and applicant(s) described in this application hereby apply for a permit to develop
the project described in this application and accept the following:
Applications shall not be considered properly filed and vested for rights to review under a set of regulations until fees
are paid in full and all items necessary to determine compliance with this bylaw are complete and submitted, this
includes any Department of Public Works permits (ie Highway Access and Water/Wastewater Connection permits;
Vermont law allows the Zoning Administrator 30 days to act on this application, however, an expedited review
within 5 business days may be provided with a surcharge of $75. Please confirm if you’d like expedited review and
pay the additional fee. Yes No ;
All submissions are public record available for inspection and copy; all representations made in this application and
the materials accompanying it are true, accurate and binding to the best of my knowledge; omission or misstatement
of any material fact on this application (which would warrant refusing the permit or approval) shall be grounds for
revoking the permit or approval;
Private agreements (such as covenants, deed restrictions and easements) may apply, may be more or less restrictive
than Milton's bylaws and may affect this project; it is my responsibility to disclose and comply with these agreements;
State and federal regulations may apply, may be more or less restrictive than Milton's bylaws, and may affect this
project; it is my responsibility to obtain all required state and federal permits; (Call the State’s permit specialist at 802-
477-2241 with any questions);
No development or work may commence until receipt of all applicable permits and approvals; and
If this application is approved, I must post notice on the property for the 15-day appeal period before work begins.
Owner Signature_____________________________________
Date ___ ___ /___ ___ /___ ___ ___ ___
Applicant Signature__________________________________
Date___ ___ /___ ___ /___ ___ ___ ___
ADDITIONAL PERMITS/APPROVALS APPLICABLE TO THE PROJECT (STAFF USE ONLY)
Town Highway Access Permit #
Approval Date ___ ___ /___ ___ /___ ___ ___ ___
State Highway Access Permit #
Approval Date ___ ___ /___ ___ /___ ___ ___ ___
Town Water/Wastewater Permit #
Approval Date ___ ___ /___ ___ /___ ___ ___ ___
Development Review Conditions:
State Water/Wastewater Permit #
Approval Date ___ ___ /___ ___ /___ ___ ___ ___
Act 250 Permit #
Approval Date ___ ___ /___ ___ /___ ___ ___ ___
Other
Recording Date ___ ___ /___ ___ /___ ___ ___ ___
ZONING ADMINISTRATOR PERMIT DECISION (STAFF USE ONLY)
REFERRED TO THE DEVELOPMENT REVIEW BOARD
APPROVED
This Zoning Permit takes effect on the 16
th
day after approval. THE APPEAL PERIOD EXPIRES: __ __ /__ __ /__ __ __ __
This Zoning Permit expires 2 years from date of effect. THIS ZONING PERMIT EXPIRES: __ __ /__ __ /__ __ __ __
DENIED (This decision can be appealed to the Development Review Board per Zoning Regulation Section 1060).
Reason for denial:
Signature Date ___ ___ /___ ___ /___ ___ ___ ___
! IMPORTANT ! CONDITIONS OF PERMIT APPROVAL
The applicant must apply for and receive a Certificate of Occupancy/Compliance upon completion of construction
and prior to use or occupancy. All construction must be completed in accordance with this permit and the Town of
Milton Zoning Regulations. If the approved project changes, the applicant must apply for and obtain an approved,
zoning permit amendment.
The applicant must satisfy all applicable DRB Conditions listed above and outlined in the Notice of Decision.
The applicant must pay applicable Impact Fees prior to the issuance of a Certificate of Compliance/Occupancy.
Fees are subject to change each July 1. The ordinance is online at
http://miltonvt.gov/DocumentCenter/View/414/Impact‐Fees‐PDF.
The applicant must post the 911 Address prior to requesting a Certificate of Compliance/Occupancy.
Other:
click to sign
signature
click to edit
click to sign
signature
click to edit
Town of Milton, Vermont Zoning Permit Application, Page 4 of 4, Last Revised September 3, 2019
DIRECTIONS & RESOURCES
THE REVIEW PROCESS
Once a complete application is submitted, the Zoning Administrator has 30 days to make action on the application. When approved,
the Permit Sign (P sign) will be mailed to you with the copy of the application including the conditions of the approval. You will need
to display the P sign visible from a public right-of-way during the appeal period and duration of the construction. The permit takes
effect on the 16
th
day after it is approved. The permit expires after two years. If you need an extension for the identical project, apply for
a renewal prior to your expiration date. If you change the project, you may need an amended permit. Once your project is completed,
apply for the Certificate of Compliance/Occupancy.
PROPERTY INFORMATION - Fill out the lines to provide a legal description of your property.
E-911 Address & Street: List the E911 address and street/road name of the property where project is proposed. If there is no address,
the E911 Coordinator (Zoning Administrator) will assign a new E911 Address with the Zoning Permit approval.
Parcel ID: This number can be found on your tax bill in the following format: 123456-123456. The Planning, Assessor's, or Clerk’s
Office can provide you with this information.
School Parcel Account Number (SPAN): This can be found on your tax bill in the following format: 396-123-XXXXX. The Planning,
Assessor's, or Clerk’s Office can also provide you with this information.
Deed Volume/Page: List the deed's recorded volume and page. This information can be found on the recorded deed in the Clerk's
Land Records for the property. The Planning, Assessor's, or Clerk’s Office can provide you with this information.
Zoning District: List the Zoning District that the property is in. This information can be found on the Town Website or linked here:
http://miltonvt.gov/DocumentCenter/View/560/Official-Town-Zoning-Map-Sep-2017-PDF or using the Milton Interactive Map
here: http://map.ccrpcvt.org/miltonmap/.The Planning Office can also provide you with this information.
Lot Size: This item requests the size of the lot in acres and can be found on the tax bill, lister’s card, or deed.
Road Frontage: This requests the linear feet of road frontage and can be found on your deed or survey plat if the land has been
surveyed.
Existing Use: Please list the use as defined by the Zoning Regulations, such as "single family dwelling". If you are unsure of your use,
contact the Planning Office.
PERMIT CATEGORY - Check the box that applies to the property's principal use.
Residential: Single family, duplex, triplex, and multi-family dwellings.
Non-residential: Commercial, industrial, institutions, etc.
Mixed Use: Any mix of residential and non-residential on the same lot, typically a mixed use planned unit development.
PERMIT TYPE - Check the boxes that apply
New Principal Building or Unit: Construction of a new building housing a principal use or creation of a new unit for a principal use.
New Accessory Structure: STRUCTURE on the same lot with, and of a nature customarily and clearly incidental and subordinate to,
the PRINCIPAL Structure. A STRUCTURE is defined as “Anything constructed or erected, the use of which requires location on or
within the ground or attachment to something having location on or within the ground." Examples include: pools, decks, patios, etc.
Alteration of Existing Structure: Structural changes, rearrangement, change of location, or addition to a STRUCTURE other than
repairs and modification in building equipment.
Change of Use: Changing the USE of a unit or lot. For example, changing from “retail” to “personal service” use.
Demolition/Removal: Demolition or removal of any structure.
Sign: Signage for business, advertising, home occupation or temporary use. List the one-sided square footage for the sign.
Amendment to Prior Permit: If you change the size, location, use, etc from what was approved on the original permit, you will need
to amend your zoning permit, as long as it has not expired. List the prior permit number.
Renewal: If the work has not been completed, the applicant shall apply to the Zoning Administrator for a one-year extension for the
identical project only. A renewal permit must be applied for prior to the expiration of the original permit. List the prior permit number.
LANDOWNER/APPLICANT - Provide the name and contact information for the owner(s) that appear on the deed and applicants if
different than the owner.
PROJECT INFORMATION - Fill out development information and answer all questions; contact the State as required.
Proposed Use: Provide the proposed use as defined in the Zoning Regulations.
Value of Development: Estimate the approximate value change associated with the use.
Total New Finished Area: List the finished areas (living space) including enclosed decks and porches.
Total New Unfinished Area: List the unfinished areas which includes garages, unenclosed decks and porches, sheds, pools, etc.
Max. Height: List the maximum height of the new structure proposed or the structure being amended.
# of Stories: List the number of stories of the proposed or amended structure.
Description of Land Development – Describe the project in detail, including any dimensions (when applicable).
SITE DRAWING OF THE PROPERTY
Use the grid to draw an aerial view of the entire property including the proposed structures. If you have a site plan or supplemental
drawings, feel free to attach them to the application. You may find it helpful to use the Milton Interactive Map at
http://map.ccrpcvt.org/miltonmap/ to see an image of your property's tax map boundaries. Please note that this is not a survey and
the satellite imagery may not match up to your actual property boundaries.
ADDITIONAL PERMITTING
If answering yes to any of the questions, read the text and provide additional information prior to submitting the application.
LANDOWNER & APPLICATION ACKNOWLEGEMENT – Read all the information provided above the signature lines and the
landowner(s) and any applicant(s) must sign the permit application.