CITY OF CHARLOTTE
APPLICATION FOR ZONING USE PERMIT
PRESS FIRMLY
ALL YELLOW AREAS MUST BE COMPLETED
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STREET # (N,S,E,W) STREET NAME (AV,RD,ST, etc)
___________ ______ __________________________________________________________ ______________
SUITE/UNIT(S): __________________________________
PROPERTY OWNER __________________________________________ ADDRESS ____________________________________________________________________
CITY ____________________________________ STATE ______________ ZIP ____________ PHONE # ____________________________________________________
APPLICANT’S NAME / CONTRACTOR __________________________________________ ADDRESS ______________________________________________________
CITY ____________________________________ STATE _____________ ZIP ____________ PHONE # ____________________________________________________
PERMIT #
TAX PARCEL #
PERMITTED INTENDED USE
PROJECT #
ABC INSPECTION - USE _____________________________________
ABC INSPECTION - FOR EDEE USE (12.546) (COMPLETE ABOVE)
ACCESSORY STRUCTURE (12.106)
(MUST ADD DIMENSIONS ABOVE)
DESCRIPTION ____________________________________________
ADULT CARE HOME (12.502)
AMATEUR RADIO FACILITY (12.108(10)) - TOTAL HEIGHT _________
BOARDING HOUSE (12.520)
CHANGE OF ZONING USE
APPROVED USE ___________________________________________
CHILDCARE CENTER IN RESIDENCE
(12.502)
(6-12 CHILDREN)
FAMILY CHILDCARE HOME (12.502) (1-8 CHILDREN)
GROUP HOME (12.517)
LAND USE _____________________________________________
MOBILE CAR WASH (B-2, I-1 OR I-2) (TEMPORARY - UP TO 90 DAYS)
ZONING: _____________________________ BUILDING DIMENSIONS: WIDTH ______________ x DEPTH ______________ HEIGHT _______________
MINIMUM SETBACKS: FRONT___________ LEFT SIDE____________ RIGHT SIDE____________ REAR____________ REQ. PARK’G______________
LAND AREA / ACRAGE (sq. ft.) ___________________________ SWIM BUFFER: No Yes _____________________ HOLD REQUIRED: No Yes
WATERSHED: No Yes ____________________________ SURVEY REQUIRED: No Yes TREE SAVE: No Yes
REMARKS / CODE SECTION: __________________________________________________________________________________________________________________
EDEE ONLY: OUTDOOR SEATING / ACTIVITY AREA No Yes
OUTDOOR SEATING / ACTIVITY AREA OPEN 11:00 PM TO 8:00 AM? No Yes CLASS A BUFFER REQUIRED? No Yes
OUTDOOR SEATING / ACTIVITY AREA MEETS 100 FT. 250 FT. 400 FT. SEPARATION TO SINGLE FAMILY DISTRICT.
MOBILE FOOD TRUCK 1 (12.510)
MOBILE FOOD TRUCK 1 - SPECIAL (12.510)
MOBILE FOOD TRUCK 3 (12.510)
MOBILE FARMERS MARKET (12.547)
OFF-SITE DEMOLITION LANDFILL (12.503)
ON-SITE DEMOLITION LANDFILL (12.405)
OUTDOOR FRESH PRODUCE STAND (12.539)
OUTDOOR SEASONAL SALES (12.519)
PARKING
PERIODIC RETAIL SALES EVENT- OFF PREMISE (12.534) (14 DAY)
PERIODIC RETAIL SALES EVENT- ON PREMISE (12.535) (4 DAY)
TENT (TEMPORARY - UP TO 90 DAYS) (ENDS ________________)
TEMPORARY CONSTRUCTION TRAILER
OTHER ____________________________________________
THE UNDERSIGNED HEREBY CERTIFIES THAT HE/SHE IS EITHER THE OWNER OR THE AUTHORIZED AGENT OF THE OWNER AND HEREBY MAKES APPLICATION FOR
PERMIT AND INSPECTION OF WORK DESCRIBED AND AGREES TO COMPLY WITH ALL APPLICABLE LAWS REGULATING THE WORK.
APPROVAL MAY BE REQUIRED FROM OTHER AGENCIES PRIOR TO ISSUING A PERMIT. THIS PERMIT WILL EXPIRE IF WORK HAS NOT STARTED AND INSPECTED
WITHIN 6 MONTHS, OR IF WORK HAS BEEN DISCONTINUED FOR A PERIOD OF 12 MONTHS. A SEPARATE PERMIT WILL BE REQUIRED FOR SIGNS ERECTED, IF
APPLICABLE. NO REFUNDS WILL BE PROCESSED AFTER ISSUANCE OF THIS PERMIT.
PREVIOUS USE _______________________________________________ INTENDED USE ____________________________________________________________
BUSINESS NAME ____________________________________________________________________________________________________________________________
CONTRACTOR ACCOUNT # _________________________
PLACARD ISSUED: No Yes
___________________________________________________________ ____________ ______________________________________________________________________
APPLICANT’S SIGNATURE DATE PRINT APPLICANT’S NAME
Make checks payable to:
CITY OF CHARLOTTE
C/O NBS-Zoning & Permitting Division
700 North Tryon Street Charlotte, NC 28202
ORIGINAL-White INSPECTOR-Blue CUSTOMER-Yellow
METHOD OF PAYMENT
CASH/CHECK ACCOUNT
APPROVED BY / DATE
EMERALD RQ # __________________________
TOTAL FEE $
CITY OF CHARLOTTE
APPLICATION FOR ZONING USE PERMIT
PRESS FIRMLY
ALL YELLOW AREAS MUST BE COMPLETED
L
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A
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N
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N
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STREET # (N,S,E,W) STREET NAME (AV,RD,ST, etc)
___________ ______ __________________________________________________________ ______________
SUITE/UNIT(S): __________________________________
PROPERTY OWNER __________________________________________ ADDRESS ____________________________________________________________________
CITY ____________________________________ STATE ______________ ZIP ____________ PHONE # ____________________________________________________
APPLICANT’S NAME / CONTRACTOR __________________________________________ ADDRESS ______________________________________________________
CITY ____________________________________ STATE _____________ ZIP ____________ PHONE # ____________________________________________________
PERMIT #
TAX PARCEL #
PERMITTED INTENDED USE
PROJECT #
ABC INSPECTION - USE _____________________________________
ABC INSPECTION - FOR EDEE USE (12.546) (COMPLETE ABOVE)
ACCESSORY STRUCTURE (12.106)
(MUST ADD DIMENSIONS ABOVE)
DESCRIPTION ____________________________________________
ADULT CARE HOME (12.502)
AMATEUR RADIO FACILITY (12.108(10)) - TOTAL HEIGHT _________
BOARDING HOUSE (12.520)
CHANGE OF ZONING USE
APPROVED USE ___________________________________________
CHILDCARE CENTER IN RESIDENCE
(12.502)
(6-12 CHILDREN)
FAMILY CHILDCARE HOME (12.502) (1-8 CHILDREN)
GROUP HOME (12.517)
LAND USE _____________________________________________
MOBILE CAR WASH (B-2, I-1 OR I-2) (TEMPORARY - UP TO 90 DAYS)
ZONING: _____________________________ BUILDING DIMENSIONS: WIDTH ______________ x DEPTH ______________ HEIGHT _______________
MINIMUM SETBACKS: FRONT___________ LEFT SIDE____________ RIGHT SIDE____________ REAR____________ REQ. PARK’G______________
LAND AREA / ACRAGE (sq. ft.) ___________________________ SWIM BUFFER: No Yes _____________________ HOLD REQUIRED: No Yes
WATERSHED: No Yes ____________________________ SURVEY REQUIRED: No Yes TREE SAVE: No Yes
REMARKS / CODE SECTION: __________________________________________________________________________________________________________________
EDEE ONLY: OUTDOOR SEATING / ACTIVITY AREA No Yes
OUTDOOR SEATING / ACTIVITY AREA OPEN 11:00 PM TO 8:00 AM? No Yes CLASS A BUFFER REQUIRED? No Yes
OUTDOOR SEATING / ACTIVITY AREA MEETS 100 FT. 250 FT. 400 FT. SEPARATION TO SINGLE FAMILY DISTRICT.
MOBILE FOOD TRUCK 1 (12.510)
MOBILE FOOD TRUCK 1 - SPECIAL (12.510)
MOBILE FOOD TRUCK 3 (12.510)
MOBILE FARMERS MARKET (12.547)
OFF-SITE DEMOLITION LANDFILL (12.503)
ON-SITE DEMOLITION LANDFILL (12.405)
OUTDOOR FRESH PRODUCE STAND (12.539)
OUTDOOR SEASONAL SALES (12.519)
PARKING
PERIODIC RETAIL SALES EVENT- OFF PREMISE (12.534) (14 DAY)
PERIODIC RETAIL SALES EVENT- ON PREMISE (12.535) (4 DAY)
TENT (TEMPORARY - UP TO 90 DAYS) (ENDS ________________)
TEMPORARY CONSTRUCTION TRAILER
OTHER ____________________________________________
THE UNDERSIGNED HEREBY CERTIFIES THAT HE/SHE IS EITHER THE OWNER OR THE AUTHORIZED AGENT OF THE OWNER AND HEREBY MAKES APPLICATION FOR
PERMIT AND INSPECTION OF WORK DESCRIBED AND AGREES TO COMPLY WITH ALL APPLICABLE LAWS REGULATING THE WORK.
APPROVAL MAY BE REQUIRED FROM OTHER AGENCIES PRIOR TO ISSUING A PERMIT. THIS PERMIT WILL EXPIRE IF WORK HAS NOT STARTED AND INSPECTED
WITHIN 6 MONTHS, OR IF WORK HAS BEEN DISCONTINUED FOR A PERIOD OF 12 MONTHS. A SEPARATE PERMIT WILL BE REQUIRED FOR SIGNS ERECTED, IF
APPLICABLE. NO REFUNDS WILL BE PROCESSED AFTER ISSUANCE OF THIS PERMIT.
PREVIOUS USE _______________________________________________ INTENDED USE ____________________________________________________________
BUSINESS NAME ____________________________________________________________________________________________________________________________
CONTRACTOR ACCOUNT # _________________________
PLACARD ISSUED: No Yes
___________________________________________________________ ____________ ______________________________________________________________________
APPLICANT’S SIGNATURE DATE PRINT APPLICANT’S NAME
Make checks payable to:
CITY OF CHARLOTTE
C/O NBS-Zoning & Permitting Division
700 North Tryon Street Charlotte, NC 28202
ORIGINAL-White INSPECTOR-Blue CUSTOMER-Yellow
METHOD OF PAYMENT
CASH/CHECK ACCOUNT
APPROVED BY / DATE
EMERALD RQ # __________________________
TOTAL FEE $
CITY OF CHARLOTTE
APPLICATION FOR ZONING USE PERMIT
PRESS FIRMLY
ALL YELLOW AREAS MUST BE COMPLETED
L
O
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A
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O
N
/
O
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N
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STREET # (N,S,E,W) STREET NAME (AV,RD,ST, etc)
___________ ______ __________________________________________________________ ______________
SUITE/UNIT(S): __________________________________
PROPERTY OWNER __________________________________________ ADDRESS ____________________________________________________________________
CITY ____________________________________ STATE ______________ ZIP ____________ PHONE # ____________________________________________________
APPLICANT’S NAME / CONTRACTOR __________________________________________ ADDRESS ______________________________________________________
CITY ____________________________________ STATE _____________ ZIP ____________ PHONE # ____________________________________________________
PERMIT #
TAX PARCEL #
PERMITTED INTENDED USE
PROJECT #
ABC INSPECTION - USE _____________________________________
ABC INSPECTION - FOR EDEE USE (12.546) (COMPLETE ABOVE)
ACCESSORY STRUCTURE (12.106)
(MUST ADD DIMENSIONS ABOVE)
DESCRIPTION ____________________________________________
ADULT CARE HOME (12.502)
AMATEUR RADIO FACILITY (12.108(10)) - TOTAL HEIGHT _________
BOARDING HOUSE (12.520)
CHANGE OF ZONING USE
APPROVED USE ___________________________________________
CHILDCARE CENTER IN RESIDENCE
(12.502)
(6-12 CHILDREN)
FAMILY CHILDCARE HOME (12.502) (1-8 CHILDREN)
GROUP HOME (12.517)
LAND USE _____________________________________________
MOBILE CAR WASH (B-2, I-1 OR I-2) (TEMPORARY - UP TO 90 DAYS)
ZONING: _____________________________ BUILDING DIMENSIONS: WIDTH ______________ x DEPTH ______________ HEIGHT _______________
MINIMUM SETBACKS: FRONT___________ LEFT SIDE____________ RIGHT SIDE____________ REAR____________ REQ. PARK’G______________
LAND AREA / ACRAGE (sq. ft.) ___________________________ SWIM BUFFER: No Yes _____________________ HOLD REQUIRED: No Yes
WATERSHED: No Yes ____________________________ SURVEY REQUIRED: No Yes TREE SAVE: No Yes
REMARKS / CODE SECTION: __________________________________________________________________________________________________________________
EDEE ONLY: OUTDOOR SEATING / ACTIVITY AREA No Yes
OUTDOOR SEATING / ACTIVITY AREA OPEN 11:00 PM TO 8:00 AM? No Yes CLASS A BUFFER REQUIRED? No Yes
OUTDOOR SEATING / ACTIVITY AREA MEETS 100 FT. 250 FT. 400 FT. SEPARATION TO SINGLE FAMILY DISTRICT.
MOBILE FOOD TRUCK 1 (12.510)
MOBILE FOOD TRUCK 1 - SPECIAL (12.510)
MOBILE FOOD TRUCK 3 (12.510)
MOBILE FARMERS MARKET (12.547)
OFF-SITE DEMOLITION LANDFILL (12.503)
ON-SITE DEMOLITION LANDFILL (12.405)
OUTDOOR FRESH PRODUCE STAND (12.539)
OUTDOOR SEASONAL SALES (12.519)
PARKING
PERIODIC RETAIL SALES EVENT- OFF PREMISE (12.534) (14 DAY)
PERIODIC RETAIL SALES EVENT- ON PREMISE (12.535) (4 DAY)
TENT (TEMPORARY - UP TO 90 DAYS) (ENDS ________________)
TEMPORARY CONSTRUCTION TRAILER
OTHER ____________________________________________
THE UNDERSIGNED HEREBY CERTIFIES THAT HE/SHE IS EITHER THE OWNER OR THE AUTHORIZED AGENT OF THE OWNER AND HEREBY MAKES APPLICATION FOR
PERMIT AND INSPECTION OF WORK DESCRIBED AND AGREES TO COMPLY WITH ALL APPLICABLE LAWS REGULATING THE WORK.
APPROVAL MAY BE REQUIRED FROM OTHER AGENCIES PRIOR TO ISSUING A PERMIT. THIS PERMIT WILL EXPIRE IF WORK HAS NOT STARTED AND INSPECTED
WITHIN 6 MONTHS, OR IF WORK HAS BEEN DISCONTINUED FOR A PERIOD OF 12 MONTHS. A SEPARATE PERMIT WILL BE REQUIRED FOR SIGNS ERECTED, IF
APPLICABLE. NO REFUNDS WILL BE PROCESSED AFTER ISSUANCE OF THIS PERMIT.
PREVIOUS USE _______________________________________________ INTENDED USE ____________________________________________________________
BUSINESS NAME ____________________________________________________________________________________________________________________________
CONTRACTOR ACCOUNT # _________________________
PLACARD ISSUED: No Yes
___________________________________________________________ ____________ ______________________________________________________________________
APPLICANT’S SIGNATURE DATE PRINT APPLICANT’S NAME
Make checks payable to:
CITY OF CHARLOTTE
C/O NBS-Zoning & Permitting Division
700 North Tryon Street Charlotte, NC 28202
ORIGINAL-White INSPECTOR-Blue CUSTOMER-Yellow
METHOD OF PAYMENT
CASH/CHECK ACCOUNT
APPROVED BY / DATE
EMERALD RQ # __________________________
TOTAL FEE $
CITY OF CHARLOTTE
APPLICATION FOR ZONING USE PERMIT
PRESS FIRMLY
ALL YELLOW AREAS MUST BE COMPLETED
L
O
C
A
T
I
O
N
/
O
W
N
E
R
I
N
T
E
N
D
E
D
U
S
E
Z
O
N
I
N
G
STREET # (N,S,E,W) STREET NAME (AV,RD,ST, etc)
___________ ______ __________________________________________________________ ______________
SUITE/UNIT(S): __________________________________
PROPERTY OWNER __________________________________________ ADDRESS ____________________________________________________________________
CITY ____________________________________ STATE ______________ ZIP ____________ PHONE # ____________________________________________________
APPLICANT’S NAME / CONTRACTOR __________________________________________ ADDRESS ______________________________________________________
CITY ____________________________________ STATE _____________ ZIP ____________ PHONE # ____________________________________________________
PERMIT #
TAX PARCEL #
PERMITTED INTENDED USE
PROJECT #
ABC INSPECTION - USE _____________________________________
ABC INSPECTION - FOR EDEE USE (12.546) (COMPLETE ABOVE)
ACCESSORY STRUCTURE (12.106)
(MUST ADD DIMENSIONS ABOVE)
DESCRIPTION ____________________________________________
ADULT CARE HOME (12.502)
AMATEUR RADIO FACILITY (12.108(10)) - TOTAL HEIGHT _________
BOARDING HOUSE (12.520)
CHANGE OF ZONING USE
APPROVED USE ___________________________________________
CHILDCARE CENTER IN RESIDENCE
(12.502)
(6-12 CHILDREN)
FAMILY CHILDCARE HOME (12.502) (1-8 CHILDREN)
GROUP HOME (12.517)
LAND USE _____________________________________________
MOBILE CAR WASH (B-2, I-1 OR I-2) (TEMPORARY - UP TO 90 DAYS)
ZONING: _____________________________ BUILDING DIMENSIONS: WIDTH ______________ x DEPTH ______________ HEIGHT _______________
MINIMUM SETBACKS: FRONT___________ LEFT SIDE____________ RIGHT SIDE____________ REAR____________ REQ. PARK’G______________
LAND AREA / ACRAGE (sq. ft.) ___________________________ SWIM BUFFER: No Yes _____________________ HOLD REQUIRED: No Yes
WATERSHED: No Yes ____________________________ SURVEY REQUIRED: No Yes TREE SAVE: No Yes
REMARKS / CODE SECTION: __________________________________________________________________________________________________________________
EDEE ONLY: OUTDOOR SEATING / ACTIVITY AREA No Yes
OUTDOOR SEATING / ACTIVITY AREA OPEN 11:00 PM TO 8:00 AM? No Yes CLASS A BUFFER REQUIRED? No Yes
OUTDOOR SEATING / ACTIVITY AREA MEETS 100 FT. 250 FT. 400 FT. SEPARATION TO SINGLE FAMILY DISTRICT.
MOBILE FOOD TRUCK 1 (12.510)
MOBILE FOOD TRUCK 1 - SPECIAL (12.510)
MOBILE FOOD TRUCK 3 (12.510)
MOBILE FARMERS MARKET (12.547)
OFF-SITE DEMOLITION LANDFILL (12.503)
ON-SITE DEMOLITION LANDFILL (12.405)
OUTDOOR FRESH PRODUCE STAND (12.539)
OUTDOOR SEASONAL SALES (12.519)
PARKING
PERIODIC RETAIL SALES EVENT- OFF PREMISE (12.534) (14 DAY)
PERIODIC RETAIL SALES EVENT- ON PREMISE (12.535) (4 DAY)
TENT (TEMPORARY - UP TO 90 DAYS) (ENDS ________________)
TEMPORARY CONSTRUCTION TRAILER
OTHER ____________________________________________
THE UNDERSIGNED HEREBY CERTIFIES THAT HE/SHE IS EITHER THE OWNER OR THE AUTHORIZED AGENT OF THE OWNER AND HEREBY MAKES APPLICATION FOR
PERMIT AND INSPECTION OF WORK DESCRIBED AND AGREES TO COMPLY WITH ALL APPLICABLE LAWS REGULATING THE WORK.
APPROVAL MAY BE REQUIRED FROM OTHER AGENCIES PRIOR TO ISSUING A PERMIT. THIS PERMIT WILL EXPIRE IF WORK HAS NOT STARTED AND INSPECTED
WITHIN 6 MONTHS, OR IF WORK HAS BEEN DISCONTINUED FOR A PERIOD OF 12 MONTHS. A SEPARATE PERMIT WILL BE REQUIRED FOR SIGNS ERECTED, IF
APPLICABLE. NO REFUNDS WILL BE PROCESSED AFTER ISSUANCE OF THIS PERMIT.
PREVIOUS USE _______________________________________________ INTENDED USE ____________________________________________________________
BUSINESS NAME ____________________________________________________________________________________________________________________________
CONTRACTOR ACCOUNT # _________________________
PLACARD ISSUED: No Yes
___________________________________________________________ ____________ ______________________________________________________________________
APPLICANT’S SIGNATURE DATE PRINT APPLICANT’S NAME
Make checks payable to:
CITY OF CHARLOTTE
C/O NBS-Zoning & Permitting Division
700 North Tryon Street Charlotte, NC 28202
ORIGINAL-White INSPECTOR-Blue CUSTOMER-Yellow
METHOD OF PAYMENT
CASH/CHECK ACCOUNT
APPROVED BY / DATE
EMERALD RQ # __________________________
TOTAL FEE $
CITY OF CHARLOTTE
C/O Planning - Zoning & Permitting Division
2145 Suttle Avenue
Charlotte, NC 28208
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