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TOWN of MILTON, VT | CERTIFICATE of COMPLIANCE (Town of Milton, Vermont)

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U.S.A. forms for Town of Milton, Vermont

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Town of Milton, VT | Certificate of Compliance/Occupancy Application | Page 1 of 2 | Last Revised September 3, 2019
TOWN of MILTON, VT | CERTIFICATE of COMPLIANCE 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.
DO NOT SUBMIT THIS FORM IF THE PROJECT DOES NOT MATCH THE APPROVED PERMIT. PLEASE CALL US.
IF THE PROJECT FAILS INSPECTION, YOU WILL NOT BE REFUNDED AND WILL HAVE TO RE-APPLY.
FILING INFORMATION (STAFF USE ONLY)
Zoning Permit ___ ___ ___ ___ - ___ ___ ___
CO Filing Date ___ ___ /___ ___ /___ ___
Expedited Review Due ___ ___ /___ ___ /___ ___
PROPERTY INFORMATION
E-911 Address/Street:
Parcel ID:
__ __ __ __ __ __ . __ __ __ __ __ __
School Parcel Account # 396 - 123 - __ __ __ __ __
Deed: Volume no. __ __ __ / Page no. __ __ __
LANDOWNER
Name(s)
Mailing Address
City
State Zip Code
Phone
Email
APPLICANT check box if same as landowner
Name(s)
Mailing Address
City
State Zip Code
Phone
Email
LANDOWNER & APPLICANT ACKNOWLEDGEMENTS
By signing this form, the landowner(s) and applicant(s) described in this application (and their agents, assigns, and
successors in interest) hereby apply for certification of the Zoning Permits referenced above and accept the
following:
The land development must match and comply with the permit above to be certified.
The Zoning Administrator or designee will be entering the property listed above.
The Zoning Regulations allows the Zoning Administrator 30 days to act on this application, however, an
expedited review within 2 or 5 business days may be provided with a surcharge of $200 or $75, respectively.
Please confirm if you’d like expedited review and pay the additional fee. Yes ( 2 day or 5 day) No
All submissions are public record and 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;
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 use or occupancy of the development may commence until receipt of all applicable permits and
certifications.
If your answer is No to any of the following questions, you may not be ready to apply for the certificate of
compliance. Please contact the Zoning Administrator to discuss.
1. Have you met all the conditions of your Development Review Board approval?.…...………… Yes No N/A
2. Has DPW/State (circle applicable) performed inspection for the approved Access Permits?… Yes No N/A
3. Has DPW performed an inspection on water/sewer (circle applicable) hook-ups?..................... Yes No N/A
4. Have all conditions of State Water/Wastewater Permit been met?................................................. Yes No N/A
5. Have you recorded your RBES/CBES Certificate?............................................................................. Yes No N/A
6. Have you provided a HUD Form 309 to the Zoning Administrator?.............................................. Yes No N/A
7. Have you paid your Impact Fees?......................................................................................................... Yes No
N/A
8. Have all conditions of other permits associated with this project been met?................................. Yes No N/A
Landowner Signature_________________________________
Date ___ ___ /___ ___ /___ ___ ___ ___
Applicant Signature__________________________________
Date___ ___ /___ ___ /___ ___ ___ __
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Town of Milton, VT | Certificate of Compliance Application | Page 2 of 2 | Last Revised September 3, 2019
INSPECTION REPORT (STAFF USE ONLY)
ZONING PERMIT
Site inspection performed by ______________________________________________ on [date] ___ ___ /___ ___ /___ ___ ___ __
E-911 Address Posted? Not Applicable (no new unit) | Yes | No
Development, use & dimensions comply with permit? Not Applicable| Yes | No, because:
Development Review
Prior development review?
No | Yes, Case Description(s)__________________________________________________________
Decision review performed by ______________________________________________ on [date] ___ ___ /___ ___ /___ ___ ___ __
Development review conditions met? :
Not Applicable | Yes | No, because:
Impact Fee
Impact Fee(s) Paid? Not Applicable (no new dwelling unit) |
Yes [date paid] ___ ___ /___ ___ /___ ___ ___ ___ | No
________________________________________________________________________________________________________________
Energy Standards Certificate
RBES/CBES Certificate Recorded in the Land Records? Not Applicable |
Yes: Book _____, Page _____ | No
________________________________________________________________________________________________________________
New Manufactured Home
Was the HUD 309 form provided? Not Applicable |
Yes | No
________________________________________________________________________________________________________________
General
All other Zoning Permit conditions met? Not Applicable (no other conditions)|
Yes | No, because:
WATER/WASTEWATER PERMIT
Town Water Permit #______________________ Town Wastewater Permit #______________________
Inspection performed by ______________________________________________ on ___ ___ /___ ___ /___ ___ ___ ___
Connection Fee Paid? Yes on ___ ___ /___ ___ /___ ___ ___ ___ | No
Development complies with permit?
Yes | No, because:
Signature Date ___ ___ /___ ___ /___ ___ ___ ___
HIGHWAY ACCESS PERMIT
Town Highway Access Permit #____________________
Inspection performed by ______________________________________________ on ___ ___ /___ ___ /___ ___ ___ ___
Development complies with permit?
Yes | No, because:
Signature Date ___ ___ /___ ___ /___ ___ ___ ___
NEW PRIVATE ROAD
Was the Engineer Certification Letter provided? Not Applicable|
Yes | No, because:
CERTIFICATION DECISION BY ZONING ADMINISTRATOR (STAFF USE ONLY)
APPROVED (ZR Section 1010 fully met, you are hereby issued a Certificate of Compliance/Occupancy for the permit(s) listed above)
DENIED (This decision can be appealed to the Development Review Board per Zoning Regulation Section 1060).
Reason for denial and/or conditions of approval:
Zoning Administrator Signature Date ___ ___ /___ ___ /___ ___ ___ ___
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TOWN of MILTON, VT CERTIFICATE of COMPLIANCE (Town of Milton, Vermont)

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Completed 19 January 2021

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