Historic District Commission

Office Use Only: HD # ____________________

Application for Certificate of Appropriateness

Minor Work (Section 17-96) - Short Form

(Applicant) What are the best ways to contact you?

Mobile

Home

Business

Applicant's Mobile number

Applicant's Business number

Applicant's Home number

Applicant's Email

Are you the property owner?

YES

Provide contact information for owner. (Must provide at least one.)

Mobile

Home

Business

Property Owner Mobile number

Property Owner Business number

Property Owner Home number

Property owner's email address:

Is this a business?

YES

Name of business:

Minor work items require Certificate of Appropriateness but may be approved by an administrative official designated by the Commission if the work is consistent with the review criteria. Minor work consists of various minor projects where the exterior appearance of the structure or landscape is not significantly changed, including but not limited to the items listed below.

Please checkbox the item best suited to your request.

Provide a description for the side and rear yard fences and walls:

Provide a description for the landscaping project:

Provide a description for new roof coverings:

Provide a description for the installation of mechanical equipment:

Provide a description for chimney and foundation repairs:

Provide a description for site improvements:

Provide a description for painting and/or repainting:

Provide a description for installation of artificial siding:

Provide a description for exterior lighting fixtures:

Provide a description for removal of asbestos or other artificial siding:

Provide a description for replacement of exterior stairs, landings and steps:

Describe clearly and in detail all exterior architectural alterations to be made. Drawings, photographs, specifications MUST accompany this application, and any other graphic information deemed appropriate. Include information on materials, paint colors, and, if necessary, information on and location of significant, large trees on site, parking areas, etc.

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.

Include any additional exterior architectural alterations to be made:

Upload files, drawings, photographs, and specifications:

Click Here to Upload

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

Property Permission

YES without any type of notification

YES with notification either by email or phone

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.

YES

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

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Receipt

You will be provided with a Receipt upon submission.