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PETITION/FILE NO. RECEIVED NOTIFICATION PICK-UP AMT PAID CHECKNO. DEPARTMENT REVIEW A.P. Midgett Municipal Building 302 Colonial Avenue P.O. Box 347 Elizabeth City, NC 27909 (252) 337-6672 Review Date _ Staff Decision (Initial) APPROVED DENIED Complete this application in compliance with Article XI Section 11-4.42 of the Unified Development Ordinance. In order to ensure that the proposed business operation and land use are permissible and all development standards comply with City regulations, the applicant is recommended to review the City of Elizabeth City s Home Occupation Ordinance; the Ordinance may be accessed at http://www.ci.elizabeth-city.nc.us/. The Home Occupation Permit application fee is $100.00. This does not include the cost of the privilege license, sign permit or construction permits. All fees are charged per application, and are non-refundable and non-transferrable once the application has been processed. Applications will not be reviewed unless fees have been paid in full. Applications are not accepted via facsimile or email. Submit the completed permit application and Privilege License application, along with supporting documents, and fees to the City of Elizabeth City Planning Department via delivery or U.S. Mail. Allow at least 3-5 business days for review and processing of all applications. Depending on the nature of your business operation and land use, a prospective proprietor may require additional review and authorization from City and non-city agencies before being issued a Home Occupation Permit and Privilege (Business) License. For more information, consult the City of Elizabeth City Customer Service New Business Guide or by calling the Customer Service Division (252) 338-3981. PLEASE COMPLETE ALL SECTIONS OF THE APPLICATION INCOMPLETE APPLICATIONS WILL BE RETURNED TO APPLICANT INDICATE NOT APPLICABLE OR N/A WHERE APPROPRIATE January 2011

SECTION A APPLICANT INFORMATION Business Owner s/applicant s name Name of Business Physical address of the property Tax Map/PIN Daytime Telephone Number Land Owner Name/Entity Alternate Telephone Number Email Address Applicant s Signature SECTION B OCCUPATION & PROPERTY INFORMATION 1. Does the owner of the business live in the dwelling on the premises? Yes No 2. Total square feet in dwelling: _ 3. Total square feet used in business: _ 4. Are there or will there be any signs on the property advertising your business? _ Yes No 5. Do you, or will you, be storing any materials or keeping any equipment or vehicles relating to the business on the property outside of the dwelling? _ Yes _ No If yes describe: 6. Excluding you, the applicant, how many employees will be working on the premises? _ 7. How many parking spaces are available on the property (do not include on-street parking in your calculation)? Typical parking spaces measure 9 x18 8. Current Zoning Classification of the property: 9. Proposed Business/Use: 10. Standard Industrial Classification (SIC) Code:_ 11. For Child and Adult Daycare Operations, complete the following: a. Indicate the type of daycare facility (Child or Adult):_ b. Number of clients to be served: _ c. Has fencing been installed around any and all outdoor play areas? Yes _No Page 2 of 6

Please note the City of Elizabeth City Development Standards Fence Regulation for residential properties, Section 11-5.1. 12. For Barber/Beauty Salon Operations, complete the following: a. How many barbers, stylists, and/or technicians will be employed? _ b. How many chairs and/or work stations will be located at the business? _ 13. For Food Service Operations, complete the following: a. Have you contacted the Elizabeth City Department of Public Utilities regarding the Fats, Oils, and Grease Disposal program? _ Yes _No If yes, provide documentation that the business location has been inspected and approved by the Sanitation Superintendent. b. Have you contacted the Albemarle Regional Health Division of Environmental Health Services or NC Department of Agriculture and Consumer Services Food and Drug Protection Division regarding your food service operation? _ Yes _ No If yes, provide documentation that the business location has been inspected and approved by the respective agency. PLEASE READ AND INITIAL PRIOR TO SUBMITTING APPLICATION 1) I understand that the business I am proposing as a home occupation must meet the following general conditions: The business is to be conducted entirely within a dwelling unit where I reside. The business is to be conducted without any significantly adverse impact on the surrounding neighborhood. No goods, stock-in-trade, or other commodities are to be displayed. No on-premises retail sales, except for goods made on the premises, are allowed. Not more than one (1) person not a resident on the premises is to be employed in connection with this business The business is not to create any objectionable traffic, noise, fumes, odor, dust or electrical interference. The maximum floor space in the residence which can be utilized by this business shall be _ square feet (less than 25% of the total gross floor of a dwelling unit). 2) I understand that this home occupation must also meet the following additional conditions: SECTION C GENERAL REQUIREMENTS All material storage shall be contained within the designated area. No outside storage is allowed. Page 3 of 6

Additional parking at the residence as a result of the home occupation is prohibited, unless the Planning Director approves additional spaces accordingly to specific need. 3) We strongly recommend that the applicant review any and all Home Owners Association covenants and/or deed restrictions governing land use in their particular subdivision. While the City of Elizabeth City does not enforce civil matters, we urge each applicant to fully investigate all aspects of the use of their residence for a Home Occupation. In case of the applicant being a renter, the application is to be signed by both the applicant and the owner of the property. FOR STAFF USE ONLY DO NOT WRITE IN THIS AREA Property Ownership and Authorization Verified: _ Yes _No Current Zoning Verified As: _ No. of On-Site (Off Street) Parking Spaces Verified As: No. of On-Site (Off Street) Parking Spaces Required: SIC Verified As: Outside Agency (ARHS, Public Works, etc.) Authorizations Noted and Verified: Yes _ N/A If yes, append copies to file. Required Site Improvements, if any:_ DO NOT RELEASE PERMIT UNTIL ALL SITE IMPROVEMENTS ARE COMPLETED Permit Conditions, if any: Date Application Review Completed Page 4 of 6

SECTION D AUTHORIZATION A COPY OF THE PROPERTY LEASE AGREEMENT DOES NOT SATISFY THE AUTHORIZATION REQUIREMENT THIS FORM MUST BE COMPLETED NOTE: IF THE PERSON REQUESTING THE, TO TAKE ACTION ON A PARTICULAR PIECE OF PROPERTY IS NOT THE OWNER OF THE PROPERTY, OR UNDER CONTRACT TO PURCHASE, THEN THE ACTUAL OWNER OF THE LAND MUST COMPLETE THIS AUTHORIZATION FORM WITH HIS/HER SIGNATURE NOTARIZED. IF THE PROPERTY OWNER IS THE APPLICANT PLEASE COMPLETE THE SECTION BELOW AND SIGN AS INDICATED. FAX, SCAN, OR COPY IMAGES OF THE ORIGINAL DOCUMENT WILL NOT BE ACCEPTED. I, (LANDOWNER S NAME) am the owner of the property located within the Elizabeth City planning jurisdiction at: Street Address: I hereby authorize (OWNER OR APPLICANT S NAME) to apply with my consent for a HOME OCCUPATION PERMIT at the above noted location. I understand the business is not to be in operation until a HOME OCCUPATION PERMIT and Privilege License has been issued. I authorize the applicant to present this matter in my name as the owner of the property. I hereby authorize City Officials to enter my property to conduct relevant site inspections as deemed necessary to process the application. All information submitted and required as part of the approval process shall become public record. I, as the land owner, hereby CERTIFY THAT THE INFORMATION CONTAINED HERIN IS TRUE TO THE BEST OF MY KNOWLEDGE; AND BY ACCEPTING THIS permit (if approved) shall in every respect conform to the terms of this application and to the provisions of the Statutes and Ordinances regulating development in City of Elizabeth City. Any VIOLATION of the terms above stated immediately REVOKES this Permit and the maximum penalties allowed by law may apply to me, the applicant, and/or my agent. If there are any questions, you may contact me at: Street Address: City/State/Zip Code: _ Phone Number: Email Address: Owner s Signature: Sworn to and subscribed before me, this the day of, 20. Notary Public My commission expires: _ [SEAL] Page 5 of 6

HOME OCCUPATION PERMIT REQUIREMENTS & RESTRICTIONS DETACH SHEET FROM APPLICATION AND ATTACH TO ORIGINAL PERMIT 11-4.42 Home Occupation Article 11 Development Standards Home Occupation Requirements (A) (B) (C) (D) (E) (F) Where Required R-6, R-8, R-10, R-15, AD, RMH, CB, O&I, NB, CMU, and PUD districts. Maximum Area The area set aside for a home occupation shall occupy no more than 25 percent of the gross floor area of a dwelling unit. Outside Storage No outside storage or display of items associated with the home occupation is permitted. Operation (1) The home occupation must be conducted entirely within a dwelling unit. It must be a use which is clearly incidental and secondary to the use of the dwelling unit for residential purposes and does not change the character or outside appearance of the residence. (2) Permitted home occupations include, but are not limited to: typing services, telephone sales, barber/beauty services, doctor/dentist office, architects, insurance agency, lawyer, real estate broker, teacher, accountants, child or adult day care (5 or fewer persons), food catering, tailoring, and handcrafting, etc. (3) No on-site retail sales, except for goods made on the premises, are allowed. (4) No goods, stock-in-trade, or other commodities shall be displayed. (5) Only 1 person may be employed who is not an occupant of the residence. (6) Activities shall not generate traffic, noise, vibration, glare, fumes, odors, or electrical interference beyond what normally occurs in the zoning district in which it is located. No home occupation shall involve the use of electrical or mechanical equipment that would change the fire rating of the structure in which the home occupation is located. (7) Instruction in music, dancing, art, or similar subjects shall be limited to no more than 5 students at one time. Signs There may be one unlighted sign erected, not to exceed three feet in height and three feet in sign area. Parking The number of off-street parking spaces required shall comply with Section 11-2 Et. Seq. However, if the Planning Director determines that the number of parking spaces required is excessive for a particular home occupation, he may reduce the number of required parking spaces accordingly. Off-street parking spaces can be located in all yards; however, no more than 50 percent of the yard can be utilized for parking. DETACH SHEET FROM APPLICATION AND ATTACH TO ORIGINAL PERMIT Page 6 of 6