All applicants must sign and have their signatures notarized on the last page

Are any Continuation Sheets attached? □Yes □No If yes, how many?: _____

OFFICE USE ONLY

Method of Payment: Cash Check Credit Card:_______ VISA MC

Date Received Amount HTE Received By________________

FEE: Administrative Appeal ($300.00); Variance Application ($300.00)

Planning Department Received by:__________________________ Date: _________________

SECTION A. VARIANCE REQUEST

1. Provide the following information for the property affected.

Site Address: ____________________________________

PIN #: __________________ Lot #:_______________ Block: ____________

Subdivision: ______________________ Unit or Section: ________________

Total lot/tract size: ____________ Existing Zoning District: ______________

2. Describe the variance requested by checking one (or more) of the boxes below.

□ lot width;

□ setback;

□ height;

□ building coverage;

□ structure spacing.

Is this property located in a PDD? □Yes □No

If yes and a setback variance is sought, you must attach a copy of the homeowners’ association approval of the request.

□ buffer width standards set forth in LDO Section 7.2.3. The Minor Modification procedures were unable to address the hardship (see LDO Sec, 3.20.2(B)).

□ off-street parking or loading standards set forth in LDO Section 7.8. The minor Modification procedures were unable to address the hardship (see LDO Sec. 3.20.2 (C)).

□ height of fence or wall as provided in LDO Section 7.2.7(B).

3. The Board cannot grant a variance to written conditions adopted by Council that are part of a Special Use permit, a PDD approval, Conditional Use rezoning, or subdivision plat or site plan approval that will be varied by this request. Are you aware of any such written conditions that pertain to the property? □Yes □No

4. Describe with specificity the type, dimensions and location of the variance requested. For example, “side yard setback variance of 3 feet to allow a 7-foot setback rather than the required setback of 10 feet.” Attach a sketch of the proposed placement of structures drawn on a current survey of the property. (Show applicable pertinent information such as provision for access, parking, etc.)

Describe:________________________________________________________

________________________________________________________________

Sketch attached? □Yes □No

5. Is this application the result of a violation notice? □Yes □No

Is there any other local hearing pending or planned for this property? □Yes □ No

If Yes to either of the above, explain:_________________________________

6. Explain how this request meets the “Approval Criteria” for a variance by answering the questions below. (Note that testimony or evidence about personal inconveniences or financial burdens will not be considered. You must provide information about some peculiar or unique physical attribute of the property or other factor unique to the property.)

A. Do special circumstances or conditions exist on the property (e.g., narrowness, exceptional topographic conditions, or shape, etc.) that are not common to other areas or buildings that are similarly situated? □Yes □No

(Note: personal or family hardships do not qualify as special circumstances or conditions.)

Explain:__________________________________________________________

________________________________________________________________

B. Will practical difficulty result from strict compliance with the LDO? □Yes □No

(Note: it is not sufficient to state that the property is less valuable without a variance.)

Explain:__________________________________________________________

________________________________________________________________

C. Can there be beneficial use of the property without the variance being granted?

□Yes □No

Explain: _________________________________________________________

________________________________________________________________

D. Will the essential character of the neighborhood be substantially altered or will adjoining properties suffer substantial detriment if the variance is granted?

□Yes □No

Explain: _________________________________________________________

________________________________________________________________

E. Will the delivery of public services be adversely affected if the variance were to be granted? □Yes □No

Explain: _________________________________________________________ ________________________________________________________________

F. Did you purchase the property with knowledge of the condition you are seeking to obtain a variance for? □Yes □No

Explain:__________________________________________________________ ________________________________________________________________

G. Can the predicament you describe be mitigated though some other method?

□Yes □No

Explain: _________________________________________________________

________________________________________________________________

7. Do you propose to attach any conditions to this variance request? If so, specify the conditions(s). (Examples that might be appropriate include conditions that reduce or minimize any injurious effect the variance might have, such as in the case of a buffer width variance, a condition that you install and maintain increased vegetative plantings in the remaining buffer area.)

Proposed Conditions:

□ a ____________________________________ [describe type and size] fence

will be constructed at ____________________________________________

□ a type _____ buffer will be installed at______________________

□ other: ______________________________________________

SECTION B. SIGN VARIANCE REQUEST

1. Provide the following information for the property affected.

Site Address: ______________________________________

PIN #: __________________ Lot #:_______________ Block: ___________

Subdivision: ______________________ Unit or Section: ________________

Total lot/tract size: ____________ Existing Zoning District: ______________

2. Describe the variance requested by checking one (or more) of the boxes below.

□ setback standards for real estate signs set forth in LDO Section 9.3.2 (Q)

□ square footage standards of wall signs set forth in LDO Section 9.3.2 (X)

□ requirements for signage in the Town Center Area set forth in LDO Section 9.6.

Has review and approval by the Town Center Review Commission been obtained

as required in LDO Section 3.20.2 (F)? □Yes □No

3. The Board may not grant a sign variance that varies any written conditions adopted by Council as part of a Special Use permit, a PDD approval, Conditional Use rezoning, or subdivision plat or site plan approval. Are you aware of any such written conditions that might conflict with this request? □Yes □No

4. Describe with specificity the type, dimensions and location of the variance requested. (For example, “vary the square footage standards for wall sign on a building to permit an additional 5 square feet of wall sign. The sign shall be located on the front elevation”.)

Describe:________________________________________________________

________________________________________________________________

Attach a sketch of the proposed sign placement. Sketch attached? □Yes □No

5. Is this application the result of a violation notice? □Yes □No

Is there any other local hearing pending or planned for this property? □Yes □No

If Yes to either of the above, explain:_________________________________

6. Provide reasons and evidence demonstrating how your proposal meets the following “Approval Criteria”:

A. Do special circumstances or conditions exist on the property that is not common to other areas or buildings that are similarly situated? □Yes □No

Explain:__________________________________________________________ ________________________________________________________________

B. Will practical difficulty result from strict compliance with the sign ordinance?

□Yes □No

Explain:____________________________________________________

________________________________________________________________

C. Can there be beneficial use of the property without the variance being granted?

□Yes □No

Explain:__________________________________________________________

________________________________________________________________

D. Will the essential character of the neighborhood be substantially altered or will adjoining properties suffer substantial detriment if the variance is granted?

□Yes □No

Explain:__________________________________________________________

________________________________________________________________

E. Will the delivery of public services be adversely affected if the variance were to be granted? □Yes □No

Explain:__________________________________________________________ ________________________________________________________________

F. Did you purchase the property with knowledge of the condition you are seeking to obtain a variance for? □Yes □No

Explain: _________________________________________________________ ________________________________________________________________

G. Can the predicament you describe be mitigated though some other method?

□Yes □No

Explain:__________________________________________________________

________________________________________________________________

7. Do you propose to attach any conditions to this variance request? If so, specify the conditions(s).

Proposed Conditions:_______________________________________________

________________________________________________________________

SECTION C. ADMINISTRATIVE APPEAL

Note: Appeals of enforcement decisions must first be appealed to the Town Manager, or designee, as provided in 11.2.2.

1. Provide the following information for the property affected.

Site Address: __________________________________________________

PIN #: __________________ Lot #:_______________ Block: ____________

Subdivision: ______________________ Unit or Section: ________________

Total lot/tract size: _____________ Existing Zoning District: _____________

2. Attach a copy of the order, requirement, permit, decision, determination refusal or interpretation made by an administrative officer of Planning or Engineering (“decision”) you are appealing. If this is an appeal of an enforcement decision, attach the decision of the Town Manager as required by LDO Section 11.2.2. Decision attached? □Yes □No

3. Describe with specificity which provisions or portions of the decision you are appealing.

Describe:_________________________________________________________

________________________________________________________________

4. Fully explain why you think the LDO has been misinterpreted or inaccurately applied and how the administrative officer erred in the application or interpretation of the terms of the LDO or related policies of the Town.

Explain:__________________________________________________________ ________________________________________________________________

5. If you are not the land owner, or if the decision was not issued to you, describe how you are aggrieved by the decision.

Explain:__________________________________________________________ ________________________________________________________________

SECTION D. APPEAL OF CIVIL PENALTY

Note: appeals of civil penalties must be first made to the Town Manager, as provided in LDO Section 11.2.2(B).

1. Provide the following information for the property affected.

Site Address:_____________________________________________________

PIN #:_______________ Lot #:_______________ Block:__________________

Subdivision:______________________ Unit or Section:___________________

Total lot/tract size:___________ Existing Zoning District: _________________

2. Attach a copy of the determination made by the Town Manager (“decision”) you are appealing. Decision attached? □Yes □No

3. Fully explain why you think the Town Manager misinterpreted or inaccurately applied the LDO and how the Manager erred in the application or interpretation of the terms of the LDO or related policies of the Town. You may address:

q the gravity of the violation

q action you took to correct the violation

q the cost of any action you took to correct the violation

q previous violations by you on this site or others

4. If you are not the land owner, or if the penalty was not issued to you, describe how you are aggrieved by the decision.

Explain:__________________________________________________________ ________________________________________________________________

CERTIFICATION

I, ________________________, the undersigned, being first duly sworn, depose and say that I am the _____owner, _____attorney, _____attorney-in-fact, _____agent, _____lessee, or _____representative of the owner(s) of the property described and which is the subject matter of this application; that all answers to the questions in this application, and all sketches, data and other supplementary information attached to this application are honest and true to the best of my knowledge and belief. If I am not the owner of the property, I have attached a notarized authorization from the owner(s) to submit with this application.

______________ ____________________________________

Date Signature

_____________County, North Carolina

Signed and sworn to or affirmed before me this day by ______________________.

_______________ _______________________________________

Date , Notary Public

(Official Seal) My commission expires: ___________________

NOTARIZED AUTHORIZATION OF ALL OWNERS

_______ COUNTY

STATE OF NORTH CAROLINA

I/We certify that I/we am/are all of the Owner(s) of the property which is the subject of this application, that I/we have authorized the applicant to make this application and that I/we agree to be bound by the application, the representations made and the decision in the same manner as if I/we were the applicant.<