ZONING PERMIT APPLICATION
Please review the Richmond Zoning Regulaons and provide all the
informaon requested in this applicaon. Addional local permits and approvals may also be required
(such as access permits, water & sewer allocaons, E911 address assignments.) For informaon contact
the Zoning Administrave Ocer at 802-434-2430. Other federal, state and local permits or approvals
may addionally be required, it is the duty of the applicant to obtain all relevant and applicable approv-
als. To inquire about State permits contact the State Permit Specialist at 802-477-2241.
Permit #
Parcel ID: _____________
Applicaon Date: ______________ Physical Address of Property: _____________________________________________________
Applicant Name: ______________________________________
Applicant Mailing Address: ______________________________
____________________________________________________
____________________________________________________
Phone: ______________________________________________
Email: _______________________________________________
Property Owner Name: _________________________________
Owner Mailing Address: ________________________________
____________________________________________________
____________________________________________________
Phone: ______________________________________________
Email: _______________________________________________
Descripon of Project: ________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Zoning District: ____________________ Is property in oodplain? __________________ Size of property (acres)? ______________
Current Use of Property: _______________________________________________________________________________________
Proposed Use of Property: _____________________________________________________________________________________
Project Dimensions: Total new square footage: _________ Length x Width x Height (): ____________________________________
Project setbacks: Distance of project from the property boundaries (): Right:_______ Le:________Rear:________Front:________
With this completed applicaon form please submit:
□ A Sketch Plan (see back page for info) □ The Permit Fee (see back page for info)
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 Zoning Fee: _________________
Appeal Period End Date/ Permit Eecve Date: ___________________ Cercate of Occupancy Required: YES / NO
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
NOTE: The Zoning Ocer has 30-days to act on a complete permit applicaon. Once a decision is made, this permit will be eecve at the
end of the 15-day appeal period, no construcon is allowed during the appeal period. The applicant or an interested party has the right to
appeal this permit decision within 15-days of issuance to the Richmond Development Review Board. Upon approval the applicant is respon-
sible for posng the provided “Z” poster within view of a public right-of-way. If a Cercate of Occupancy is required use or occupancy shall
not occur unl a Cercate of Occupancy is issued. An approved permit shall expire 24 months aer the appeal period end date.
Applicaon created July. 2017
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