Fill - Free fillable Town of Allenstown, NH 16 School Street Allenstown, (Town of Allenstown) PDF form

Revised February, 2012

Application Number:_____

Amount of Fee Paid: _____

Date Filed: _____

Town of Allenstown, NH

16 School Street

Allenstown, NH 03275

485-4276, Fax 485-8669

Planning Board

Conditional Use Permit Application Form

1. Owner’s Name:__________________________________________________________

Mailing Address/Street Number:_____________________________________

City & State:______________________ Telephone: ( )____________

2. Agent’s Name (if applicable):________________________________________________

Mailing Address/Street Number:_____________________________________

City & State:______________________ Telephone: ( )____________

3. Type of Conditional Use Permit Requested (please check):

i. _____Outdoor Flea Market in accordance with requirements of Article 1120 of

the Allenstown Zoning Ordinance

ii. _____Groundwater Protection Ordinance in accordance with the requirements

of Article XXIV of the Allenstown Zoning Ordinance

NOTE: CONDITIONAL USE PERMIT FOR AN ADULT BUSINESS MUST USE ANOTHER

APPLICATION FORM

4. For the property being developed, complete the following:

Street Address:___________________________________________________________

Abutting Streets:__________________________________________________________

Gross Floor Area:__________ Existing:___________ Proposed:__________

Assessor’s Map/Block/Lot(s):_______________________________________________

Project Area: Acres_________________ (or) Square Feet________________________

Revised February, 2012

5. Briefly described the proposed use of the property and the conditional use requested.

Please attach supporting justification for the requested conditional use permit – reference

each of the required criteria as outlined in the relevant zoning ordinance article as listed

above under “Type of Conditional Use Permit Requested.”

______________________________________________________________________________

6. Indicate the name, profession and telephone number of each professional involved (if

any) in the preparation of the application or its components:

Name:______________ Profession:__________________ Phone:( )________

7. Existing Zoning District(s):_________________________________________________

Overlay Districts: ________________________________________________________

8. Application Fee: Please contact the Planning Department to obtain the latest application

fee schedule. An application fee is submitted herewith in the amount of $:___________

9. Endorsement: I hereby request that the Town of Allenstown Planning Board review this

application for a Conditional Use Permit, including all plans, documents and information

herewith. I represent to the best of my knowledge and belief, this application is being

submitted in accordance with the Site Plan or Subdivision Regulations, as applicable of

the Town of Allenstown Planning Board.

______________________________________________________________________________

Signature of Property Owner Date Agent Signature (if any) Date

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Revised February, 2012

10. In accordance with the Allenstown Zoning Ordinance, ALL of the following must be met

for the Planning Board to grant a CUP for an Outdoor Flea Market:

a. Flea Market dates are limited to Saturdays, Sundays and legal Monday

Holidays;

b. Is limited between the hours of 7:00 AM and 7:00 PM;

c. Does not take place before April 15

or after October 15

;

d. Said CUP shall not be in effect until April 15

of the year of issuance

and shall expire October 16

of that same year;

e. Sufficient “off street” parking shall be provided for by the

proprietor/manager of the outdoor flea market;

f. Refuse collection and removal shall be provided;

g. Shall not be detrimental to the neighborhood or abutting properties;

h. The outdoor flea market shall comply with any other applicable

provisions of this Ordinance.

On a separate sheet of paper, please discuss how the proposal will meet the above

requirements.

11. In accordance with the Allenstown Zoning Ordinance, ALL of the following must be met

for the Planning Board to grant a CUP for requests under Groundwater Protection

Ordinance:

I. In granting such approval, the Planning Board must first determine that the

proposed use is not a prohibited use (as listed in Section IX of the Allenstown

Zoning Ordinance) and will comply with The Performance Standards and

Article VI as well as all applicable local, state, and federal requirements. The

Planning Board will require a performance guarantee or bond, in an amount

and with surety conditions satisfactory to the Board, to be posted to ensure

completion of construction of any facilities required for compliance with The

Performance Standards.

II. Conditional uses, as described under Section X part (A) of the Zoning Ordinance

(described below), using regulated substances shall submit a SPCC plan to the

Fire Chief, Police Chief, Health Officer, and Emergency Management

Director who shall determine whether the plan will prevent, contain, and

minimize releases from ordinary or catastrophic events such as spills, floods,

or fires that may cause large releases of regulated substances. The Town may

consult third party entities at the expense of the applicant to ensure

compliance. The SPCC shall include:

Revised February, 2012

(1) A description of the physical layout and a facility diagram, including all

surrounding surface waters and wellhead protection areas;

(2) Contact list and phone numbers for facility response coordinator , cleanup

contractor, and all appropriate federal, state, local agencies who must be contacted

in case of release into the environment;

(3) A list of all the regulated substances in use and locations of use and storage. This

list shall be updated annually and submitted to the parties indicated above.

(4) A prediction of the direction, rate of flow, and total quantity of regulated

substance that could be released where experience indicates a potential for

equipment failure;

(5) A description of containment and/or diversionary structures or equipment to

prevent regulated substances from infiltrating the ground.

A. For any use that will render impervious more than 15% or more than 2,500 square

feet of any lot, whichever is greater, a storm water management plan shall be

prepared in accordance with the Allenstown Permanent (Post-Construction)

Stormwater Management Ordinance.

B. Conditional uses, as defined under Section X shall develop a stormwater

management plan prepared in accordance with the Allenstown Permanent (Post-

Construction) Stormwater Management Ordinance and a pollution prevention plan

including information consistent with Developing Your Stormwater Pollution

Prevention Plan: A Guide for Industrial Operators (USEPA, Feb 2009). The plan shall

demonstrate that the use will:

1) Meet minimum stormwater discharge setbacks between water supply wells and

constructed stormwater practices as found within the Innovative Land Use

Planning Techniques: A Handbook for Sustainable Development, Section 2.1

Permanent (Post-construction) Stormwater Management, (DES, 2008 or later

edition);

2) Minimize, through a source control plan that identifies pollution prevention

measures, the release of regulated substances into stormwater;

3) Stipulate that expansion or redevelopment activities shall require an amended

stormwater plan and may not infiltrate stormwater through areas containing

contaminated soils without completing a Phase 1 Assessment in conformance

with ASTM E 1527-05, also referred to as All Appropriate Inquiry (AAI);

4) Maintain a minimum of four feet vertical separation between the bottom of a

stormwater practice that infiltrates or filters stormwater and the average seasonal

Revised February, 2012

high water table as determined by a licensed hydrogeologist, soil scientist,

engineer or other qualified professional as determined by the Planning Board.

C. Animal manures, fertilizers, and compost must be stored in accordance with Manual

of Best Management Practices for Agriculture in New Hampshire, NH Department Of

Agriculture, Markets and Food, July 2008 and any subsequent revisions.

D. All regulated substances stored in containers with a capacity of five gallons or more

must be stored in product tight containers on an impervious surface designed and

maintained to prevent flow to exposed soils, floor drains, and outside drains;

E. Facilities where regulated substances are stored must be secured against

unauthorized entry by means of a door and/or gate that is locked when authorized

personnel are not present and must be inspected weekly by the facility owner;

F. Outdoor storage areas for regulated substances, associated material or waste must be

protected from exposure to precipitation and must be located at least fifty feet from

surface water or storm drains, at least 75 feet from private wells, and outside the

sanitary protective radius of wells used by public water systems;

G. Secondary containment must be provided for outdoor storage of regulated substances

in regulated containers and the containment structure must include a cover to

minimize accumulation of water in the containment area and contact between

precipitation and storage container(s);.

H. Containers in which regulated substances are stored must be clearly and visibly

labeled and must be kept closed and sealed when material is not being transferred

from one container to another;

I. Prior to any land disturbing activities, all inactive wells on the property, not in use or

properly maintained at the time the plan is submitted, shall be considered abandoned

and must be sealed in accordance with WE 604 of The NH Water Well Board Rules;

J. Blasting activities shall be planned in accordance with any Town of Allenstown

blasting regulations and shall be conducted in a manner to minimize groundwater

contamination.

K. With the exception of delivery of heating fuel to residences, transfers of petroleum

from delivery trucks and storage containers over five gallons in capacity shall be

conducted over an impervious surface having a positive limiting barrier at its

perimeter.

Please demonstrate compatibility with the above criteria on separate sheets of paper.

Revised February, 2012

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