HomeMy WebLinkAboutZP-18-385 - 1125 Shelburne Road 10/3/2018I
CITY OF SOUTH BURLINGTON
ZONING PERMIT APPLICATION
Applicant: Kelly Ley Application No:Z
Applicant Mailing Address: 319 ELAINES COURT, DODGEVILLE, WI 53533
Applicant Email: Kelly@permit.com Daytime phone: 6 0 1. 8 -40 - 7-9086
1125 SHELBURNE RD, SOUTH BURLINGTON
Property Street Address: ----
Property Owner: VT 05403
MCDONALD'S USA, LLC Parcel Size:
6903 ROCKLEDGE DR STE 1100 BETHE Tax Parcel ID Na. 1540-011
Property Owner Mailing Address:
1. PROPOSED project including building dimensions (describe): _ -_
Interior remodel - New self ordering Kiosks, partition wall, customer service counter
finish and fixture upgrades
Z. Present USE(S) of the property:
❑ Single family home on its own parcel
Other (please state the USE per Land Development Regulations- retail, general office, multifamily residential, etc.):
RESTUARNT
3. List all present structure(s) on property (describe including dimensions or square footage of each):
N/A
4. Doesrtthe project include a proposed change of USE?
V No (the property will still be used for the same purpose)
E:Yes (please state proposed changed or added USES per Land Development Regulations- retail, general
office, multifamily residential, etc.):
5. ESTIMATED total cost of improvements (materials and labor): $50,000.00
6. Building footprint — i.e. size in sq.ft of main floor efiroM and all attached and detached structures including enclosed
breezeways, garages, and sheds (describe): Existing: 3460 Proposed: Fxi,-;ti1ig - no change
7. Total square feet of other impervious surfaces on site (i.e. driveways, patios, decks)
Existin Proposed: N,A
8. ATTACH SKETCH PLAN OR SITE PLAN (not required if project consists ONLY of interior renovations or replacement of
existing roof, siding, etc. in the exact same size)
9. APPLICANT/OWNER CERTIFICATION
The undersigned property owner hereby consents to submit this application and understands that if the application irc ;q)Im i e-iI n f,
Zoning Permit and any attached conditions will be binding on the property.
f
Property Owner Signature
PRINT NAME
Date
The undersigned applicant hereby affirms that the information presented in this application is true, acc:uratc and ( n,nploto
Kelly Ley 9/28/18
Applicant Sig ure Q PRINT NAME Date
OFFICE USE ONLY — ADMINISTRATIVE OFFICER ACTION - OFFICE USE ONLY
DATE Received: 1013FEE Received: $ z 6L3 Identification of zoning district
Identification of proposed use: I e&6-y- **j
PROPOSED USE TYPE: ffpermitted Conditional
Date of SITE PLAN approval/denial
Date of SUBDIVISION approval/ denial
Date of CONDITIONAL USE approval/ denial
Date of appeal VARIANCE approval/ denial
Approval Date
Approval Date
Approval Date
Approval Date
Denial Date
—_ Denial Date
Denial Date
Denial Date
Date of MISCELLANEOUS approval/ denial
Approval Date Denial Date
Provided applicant copy of URBEC or VCBE Standards Handbook or�lot Applicable
FINAL ADMINISTRATIVE OFFICER ACTION
/ Z O N I N G P M I T
QAPPROVED
Approval Date f Admi strative Officer's Signature
Permit EFFECTIVE date t0/ V% 1g Permit EXPIRATION date
Denial Date
REASON for DENIAL
Administrative Officer's Signature
Notice of Appeal Rights: Any interested person may appeal this decision by filing a written Notice of Appeal with t1w Off fk of the
Development Review Board within fifteen [151 days of the date of this decision. The notice of appeal must be acc:ompanwd by a firmO
fee of $223.00.
This permit does NOT authorize commencement of any development activity approved by the permit until the permit Inky,
effect as set forth above. Site modifications and improvements made prior to this permit becoming effective may be subjF!ct to rrrmtw 0
and site restoration if a timely appeal is commenced.
NOTE: The applicant or permittee retains the obligation to identify, apply for, and obtain relevant state permits for this project Call it W i
879-5676 to speak with the regional Permit Specialist.
McDonald's USA, LLC
Capitol Execution Team
6903 Rockledge Driuc, Suile uoo
Bethesda, Maryland -Io8il
McDonald's USA
September 28th, 2018
To Whom It May Concern:
On behalf of McDonald's USA, I, Asa Mayo, give State Permits authorization to act as agent
for the following project: McDonald's 12242 Site# 44-0041 - 1 125 Shelburne Rd, South
Burlington, VT 05403
Sincerely,
Asa Mayo
Area Construction Manager McDonald's USA LLC
6903 Rockledge Drive, Suite 1100, Bethesda Maryland
20817 Phone 1 240-497-3627