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City of Gastonia Planning Department

planning@cityofgastonia.com

PO Box 1748 Gastonia, NC 28053

Historic District Commission

Application for Certificate of Appropriateness

Major Work - Long Form

Property Street Address:

Applicant's Name:

Applicant's Mailing Address:

Are you the Property Owner?

Property Owner's Name

Property Owner's Mailing Address

Provide a phone number and/or email:

Major work items require a Certificate of Appropriateness and must be approved by the Commission prior to the issuance of a zoning permit. In general, these are items which involve a change in the exterior appearance of a structure or landscape and that are more substantial in nature than minor work items, including but not limited to the items listed below.

Choose the item(s) best suited to your request:

Exterior Alteration of Existing Structure

Materials submitted with Application:

Upload Site Plan File(s):

Click Here to Upload

Upload Elevations File(s):

Click Here to Upload

Upload Photo File(s):

Click Here to Upload

Upload Material Samples File(s)

Click Here to Upload

Upload Sketch File(s):

Click Here to Upload

Upload Other File(s):

Click Here to Upload

Applications without the abovementioned attachments or that do not provide a clear description will be considered incomplete and will not be processed until all pertinent information is provided.

I hereby give Planning staff and/or Historic District Commissioners permission to enter the property to collect information specific to this request.

Property Permission:

Applications to be heard by the full Historic District Commission must be received at least fourteen (14) business days prior to the regularly scheduled meeting, which is the fourth Thursday of every month.

I understand my application must be received at least fourteen (14) BUSINESS days prior to the regular scheduled meeting.

If you do not understand, please contact staff before completing this-application at Planning@cityofgastonia.com or 704-854-6605.  Thank you.

Full Signature:

Choose how to sign

Date Completed:

Receipt

You will be provided with a Receipt upon submission.