WSMU_HUNT_WSWP Other Info_20210412 (4)

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NORTH CAROLINA
Density Averaging Certificate
Application
INCOMPLETE SUBMISSIONS WILL NOT BE ACCEPTED. PLEASE CHECK ALL ITEMS CAREFULLY.
The terms "lot" and "parcel" are used interchangeably.
1. Description of Request
Briefly explain the nature of this request. If a separate sheet is necessary, please attach to this application.
2. Receiving Parcel Information (Receiving parcel shall not be located in the Critical Area,
CA)
* Printed Name
Phone
❑ Corporation ❑Limited Liability Company ❑ Trust ❑ Partnership ❑ Other:
Title
Address of Property Owner
Email
Signature
" Property owner hereby grants permission to the Town of Huntersville personnel to enter the subject property for any purpose required in processing
this application.
Parcel Identification Number of Receiving Lot (PIN)
Zoning District
Watershed Overlay
Property Size (acres)
Amount of Existing Impervious Lot Coverage (sf)
Amount Impervious Area Receiving from Giving Lot (sf)
Has a watershed variance ever been granted for this ❑ YES
parcel? I ❑ NO
If this application is signed by an agent on behalf of the Property Owner(s), this application MUST be accompanied by a
notarized Limited Power of Attorney signed by the property owner (s), specifically authorizing the agent to act on the
owner (s) behalf in signing this application. Failure of each owner, or their duly authorized agent, to sign, or failure to
include the authority of the agent signed by the property owner, will result in an INVALID APPLICATION. If additional
space is needed for signatures, attach the Town of Huntersville Signature Addendum Form.
Last updated June 2019
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3. Giving Parcel Information
* Printed Name
Phone
❑ Corporation ❑Limited Liability Company ❑ Trust ❑ Partnership ❑ Other:
Title
Address of Property Owner
Email
Signature
Property owner hereby grants permission to the Town of Huntersville personnel to enter the subject property for any purpose required in processing
this application.
Parcel Identification Number of Receiving Lot
Zoning District
Watershed Overlay
ProDertv Size (acres)
Amount of Existing Impervious Lot Coverage (sf)
Has a watershed variance ever been granted for this
parcel?
❑ YES
❑ NO
If this application is signed by an agent on behalf of the Property Owner(s), this application MUST be accompanied by a
notarized Limited Power of Attorney signed by the property owner (s), specifically authorizing the agent to act on the
owner (s) behalf in signing this application. Failure of each owner, or their duly authorized agent, to sign, or failure to
include the authority of the agent signed by the property owner, will result in an INVALID APPLICATION. If additional
space is needed for signatures, attach the Town of Huntersville Signature Addendum Form.
4. Site Plan Submission Schedule
Density Averaging Plats must be reviewed by the Town of Huntersville Planning Department and approved by the
Board of Adjustment. The Board of Adjustment Submittal Deadlines and Meeting Schedule can be found through the
Planning Department website.
5. Reference Information
Please see the Town Website below for the following:
• Town of Huntersville Impervious Applicability Map
• Town of Huntersville Fee Schedule
• Density Averaging Certificate Checklist
• Density Averaaina Review Process
• Town of Huntersville Zoning Ordinance Watershed Overlays
o For Parcels in the Mountain Island Lake Watershed Overlay (MIL-0), See Article 3.3.2
o For Parcels in the Lake Norman Watershed Overlay (LN-O), See Article 3.3.3
Contact Information
Town of Huntersville Phone: [phone]
Planning Department Fax: [phone]
PO Box 664 Physical Address: 105 Gilead Road, Third Floor
Huntersville, NC 28070 Website: https://www.huntersville.org/228/Planning-Department
Date Received by Staff
Last updated June 2019
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