Zoning Permit Application Cover Page

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1 Zoning Permit Application Cover Page The City of Belmont performs an initial site inspection prior to issuance of a zoning permit for new construction. Upon receipt of a full and complete application submittal via mail, in person, or online at the site inspection should occur within 48 hours. Ensure submittal of: Complete Zoning permit application Scaled site plan showing all property corners and dimensions, footprint of house, building setbacks, location of driveway and sidewalks, location of utility connections, tree save areas, and easements. For properties with any portion in the 100 year flood plain: A sealed survey from a registered surveyor must be provided and must show the contour line of the base flood elevation (100-year flood plain), proposed building footprint, finished floor elevation (FFE) of lowest inhabitable floor, elevation of bottom of floor joist for lowest FFE, and any other information the city may need to comply with adopted FEMA floodplain regulations. Plan for each floor of the house All appropriate fees Fee total for zoning permit, inspections, and water meter installation will be provided to the builder and must be paid prior to issuing the zoning permit. Water meter work order When the site is properly prepared for the water meter installation, the builder must submit an online water meter work order request using the link below. Repeat trips for unprepared sites will result in additional fees starting at $75 per trip. Please allow up to 10 working days from the requested date for installation. Requirements for lot inspection: Property corners and house corners clearly identified and staked Lot number clearly identified and displayed until final site inspection Driveway location clearly identified and staked Water meter location and sewer clean-out exposed, staked blue for water, green for sewer Within the lot boundaries At least two feet from driveway I hereby acknowledge that I have read and understand these requirements. I agree to pay reinspection fees starting at $50 per trip for locations not originally prepared for inspection. Signature

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3 City of Belmont Zoning Permit Application 37 N. Main St. P. O. Box 431 Belmont, NC Fax: Property owner(s): Lot Number Property address: Parcel ID no. (Six-digit): Owner mailing address: City, state, ZIP: Phone: Work/cell: Subdivision or development name: Applicant (if different from property owner): Mailing address: City, state, ZIP: Phone: Contractor: Mailing address: City, state, ZIP: Phone: Application for: New construction* Change in use Interior renovation Accessory building* Swimming pool* Addition/expansion* Demolition/grading Sign* Other: *A scaled site plan or plot plan must be submitted for these items. Description of project: Project cost: $ Number of bedrooms (New SFD) Lot Coverage (maximum impervious) % Lot size (sq. ft.): Lot frontage: Front setback: Left side setback: Right side setback: Rear setback: Htd. sq. ft. of house: Accessory structure information (detached garage, utility building, pool, carport, etc.): Size of bldg.: by Htd. sq. ft. of house: Left side setback: Right side setback: Rear setback: Dist. from house: Note: Dimensions in feet unless noted. Dimensions are critical for accurate measurements and must be provided.

4 Floodplain compliance Is there a stream on the property? Yes No Does project include a stream crossing? Yes No Culvert Bridge Other: Is property in a special flood hazard area? Yes No Panel: Is property in a floodway zone? Yes No Will project involve stream channel relocation? Yes No Are there any wetlands on project site? Yes No A survey from a registered surveyor must be provided and must show the contour line of the base flood elevation (100-year flood plain), proposed building footprint, finished floor elevation (FFE) of lowest inhabitable floor, elevation of bottom of floor joist for lowest FFE, and any other information the city may need to comply with adopted FEMA floodplain regulations. Grading compliance (if applicable) Company/person responsible for land disturbing activity: Address: Phone: Cell: Size of disturbed area (specify square feet or acres): A grading plan must be attached. Checklist of basic plan elements (other items may be required): Survey with contours (existing and proposed); proposed clearing limits, drainage structures, culverts, etc. Narrative explaining construction timeline Approved Gaston County sedimentation and erosion control permit Please note: If the project is located in a water supply watershed protection district, or if the area of disturbed land exceeds one acre, we may require additional material to be submitted. Contact the planning department for more information. By signing below, I agree to conform to all applicable city ordinances and zoning regulations. I also agree to obtain a building permit from Gaston County (if required), and to construct to the specifications of plans submitted and to building code standards regulating such work. I hereby affirm that the above information is accurate and correct to the best of my knowledge. Signature of applicant: Printed name: Date: Application revised 10/3/17 Page 2

5 Final Zoning Compliance Inspection Checklist As you complete building and development projects and prepare for the final county inspection, we ask you to submit a city zoning compliance inspection request online 2-5 days in advance of your desired inspection date. (For last minute changes to scheduled inspection, please reschedule before 9:00 a.m. by calling (704) to avoid additional reinspection fees.) Once all required work is performed and confirmed, we will transmit the completed inspection form to Gaston County. The city will be confirming proper installation of city utility connections, ensuring sidewalk areas are installed and have not been damaged by new construction, verifying tree planting and landscaping requirements have been satisfied, and verifying any other work performed to meet city infrastructure and zoning requirements specific to the property. Final Zoning Compliance Inspection Checklist: Compare actual construction to approved site plan Address displayed properly Driveway apron in good condition Streets in good condition Sidewalks in good condition Water meter box at grade, not damaged Sewer clean out at grade, not damaged Required on site and street trees planted Site lighting in compliance if applicable Required buffer installed where applicable Trash and debris removed from site Submit backflow prevention report if applicable Submit inspection requests here 2-5 days in advance of desired inspection date: Direct questions and concerns to: Jamie Mendoza Phone: (704)

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