Fillable State of North Carolina, Department of Administration APPLICATION (North Carolina)

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State of North Carolina, Department of Administration APPLICATION (North Carolina)

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DOA-SO-00025 (September 2011)
http://www.ncfacilitymanagement.net/
State of North Carolina, Department of Administration
APPLICATION TO USE PUBLIC BUILDINGS AND/OR GROUNDS
Please print or type.
Rules and regulations adopted by the Governor and Council of State govern use of public buildings and grounds (defined by G.S. 143-336) by any individual
or group of whatever kind. Please complete Items 1 through 12 and submit one copy via mail, electronic mail (permitrequests@doa.nc.gov)
, or facsimile (919-
733-1430) at least 7 full business days before date of proposed use
to Director, Facility Management Division, 1313 Mail Service Center, Raleigh, North
Carolina 27699-1313. Failure to comply with these regulations is punishable at the discretion of the Court under G.S. 143-345.1. Note that permits requests
will not be considered more than one year in advance of the event date.
1. Public Building(s) and/or Grounds applied for: 2. Date of Application:

3. Date Desired: 4. Time Desired (limit of 4 hours): 5. Expected Attendance
From: To:
6. Describe Intended Usage. Provide Goals, Objectives, or Purpose for this Permit Request:
Will Tent or Canopy be used during the event? If Yes, what size:
Attach a copy of the REQUIRED Tent or Canopy
approval.
Check if needed: Electrical Power (voltage and amps): Trash Cans Recycle Bins
7. State Agency, Organization or Individual Making Request and Secretary/Executive involved if applicable: Phone:
Address: Fax:
Email Address:
8. Contact Person accepting Responsibility for Event: Phone:
Address: Fax:
Email Address:
9. Give requested information about expected active participants (speakers, leaders, etc.) Attach separate sheet, if necessary.
Name Address Phone
10. Use separate sheet to list names, titles, and addresses of all officers and board members of organization, corporation, or group.
11. Applicant Signature (print name and sign):
12: I have read and understand the regulations listed on the reverse
side of this form. Responsible Person Signature (print name and sign):
**** THE SECTION BELOW IS TO BE COMPLETED BY INTERNAL REVIEW STAFF ****
Securit
y
Re
q
uired? Yes No If Yes, Securit
y
p
rovided b
y
State Ca
p
itol Police Cit
y
of Ralei
g
h Other
Number of Officers Needed:
Recommend Approval Duration Officers Needed:
Recommend Disapproval
Approved by Chief, State Capitol Police Date
Permit Approved Permit Number:
Permit Denied
Approved by Director,
Facility Management Division
Date
INSTRUCTIONS AND REGULATIONS
1.
Permits ordinarily will be issued for a maximum of four (4) hours, excluding setup and cleanup. Requests for an
extended time period may be granted upon fully documented need. Requests will not be considered more than one
year in advance of the event date. The Department of Administration reserves the ability to reasonably adjust the time
or location of permitted uses to accommodate government operations, public order and safety.
2. Permit holder is responsible for the removal of all trash generated from activity conducted on state grounds.
3. Events held during work hours (7:30 a.m. to 5:30 p.m. Monday through Friday) affect employees in nearby offices.
Public address (PA) systems to amplify voice are permitted, but the sound should not be audible more than 100 feet
from the speaker location.
4. Electrical outlets are generally available but are the permit holder’s responsibility to confirm in advance of the event.
Water hook-ups are not provided.
5. Regardless of which site is authorized by permit to use, do not block entrances, exits or sidewalks. These must
always be available for pedestrians and visitors to the building.
6. Inside of public buildings, utilization of public corridors must ensure that no entrance, exit, restroom or office doors
are blocked and that handicapped accessibility is not impeded. Guests must be mindful of their impact on employees
working in these facilities.
7. VEHICLE USE AND PARKING:
a. Parking is not permitted on the State Capitol grounds, Bicentennial Mall and Halifax Mall. Use of vehicles at
permitted sites is restricted to loading and unloading purposes. Violation of terms may result in permit
cancellation and future denials.
b. Vehicles are only permitted in the designated area of the Halifax Mall between the Education and Revenue
buildings for loading and unloading purposes. Lightweight vehicles such as a golf cart may be used to transport
materials and supplies from this area to the event area.
c. Visitor parking is available at the corner of Wilmington and Jones streets.
8. RULES SPECIFIC TO THE STATE CAPITOL BUILDING:
a. In addition to submitting this permit application, all requests for the State Capitol must notify the State Capitol
Historic Site office at 919-733-4993 and ask for its permit request form. This Application to use Public Buildings
and/or Grounds is only for a request to use the grounds and does not include access to the State Capitol.
b. Vehicles are only permitted in the driveway loop on the north side of the Capitol Building for loading and
unloading purposes. Parking on sidewalks is expressly prohibited.
9. USE OF TENTS AND CANOPIES:
a. Tents and membrane structures with an area in excess of 200 square feet and canopies in excess of 400 square
feet shall not be erected, operated or maintained for any purpose without first obtaining a permit and approval
from the State Construction Office
.
b. Specific rules regarding erection of tents and canopies are available from the State Construction Office, 919-807-
4100. Ask for a Code Consultant if you have questions. The authorization request form is available online at
http://www.nc-sco.com/documents.aspx
.
c. Tent/canopy approvals from the State Construction Office must be submitted no later than 36 hours before
installation. Failure to submit tent/canopy approvals may result in cancellation of permit.
d. All tents/canopies used must be weighted and not stake driven. The structure will be inspected by the
appropriate fire code official on the day it is constructed. Any structure that is in violation of NC Fire Code or not
specifically approved by permit must be removed. If not removed, the event permit will be terminated.
e. State Construction Office mailing address is 1307 Mail Service Center, Raleigh, NC 27699-1307 (Courier Number
56-02-01). Plans may be delivered to its offices located in the Education Building, 301 N. Wilmington St., Suite
450, Raleigh, or faxed to 919-807-4110.
Rev. September 2011
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State of North Carolina, Department of Administration APPLICATION (North Carolina)

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Completed 24 March 2022

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