Form OA-1
(Rev. 09/15)
North Carolina Department of Transportation
Application for Outdoor Advertising Permit
Application is hereby made in triplicate for a permit to CONSTRUCT and MAINTAIN an outdoor advertising sign as located and described below, in accordance with provisions of the OUTDOOR ADVERTISING CONTROL ACT OF 1967, Article 11, Chapter 136 of the General Statutes of North Carolina.
Name of Permit Holder/Sign Owner
/Department of Transportation Use Only
Customer No. / Application No.Billing Address
Mile Post / Permit No.City/Town/State/Zip
/ R/L· / -
Telephone No.
Location of sign is on the N S E W side of Route No. / in / County situated / _.__
(nearest 1/100th) mile N S E W of / Secondary Road, Street, Route, County Line, City
Limits or other nearest location) on property owned by
PROPOSED SIGN CONFIGURATION
Length (Max. 60.0 ft) Height (Max 30.0 ft.) Area (Max 1200 Sq. Ft.)
Feet / Feet / FeetWill Sign be Lighted? (Check One) Yes No
Type of Display (Check One) 1. Back-to-Back 3. Single Face 5. Combination of 1 & 2
2. Side-by-Side 4. V-Type 6. Combination of 2 & 4
Check if Display will have Automatic Changeable Facing / If Single Face Display, orientation of sign faceNo. Display(s): / Proposed Sign Height / Ft. (Max. 50 feet measured vertically from adjacent edge of pavement)
When application is made for an outdoor advertising permit, the application shall be submitted with the following attachments:
(1) A written lease or written proof of interest in the land where a sign is proposed to be constructed.
(2) A right of entry form to provide the right of entry from the property owner and/or adjacent property owners to allow DOT personnel to enter upon the property when necessary for the enforcement of the Outdoor Advertising Control Act or these rules.
(3) If zoned, a written statement from the local zoning authority indicating the present zoning of the parcel and its effective date. Upon request of the State ODA Coordinator, the applicant shall submit copies of minutes from the appropriate zoning authority pertinent to the zoning action.
(4) If the area is an unzoned commercial or industrial area, a copy of the documentation conforming that the requirements under NCAC 02E.0203(5)(a) have been met.
(5) A sign permit or zoning permit if required by the location government having jurisdiction over the proposed location.
(6) A written certification from the sign owner indicating there has been no misrepresentation of any material facts regarding the permit application or other information supplied to acquire a permit. (Signature on this form will meet this certification requirement.)
(7) The initial nonrefundable $120 permit fee ($60 for directional sign).
Any false statements or omission of attachments above may cause rejection of application.
I hereby certify that there have been no misrepresentations of any facts regarding this application and items 1-7.
Signature (Permit Holder/Sign Owner______Date______
This application, Form OA-1 (Rev. 02/06), shall be used to apply for a permit to construct and maintain a new sign structure. Applications may be obtained from any NCDOT Regional Coordinators or from the State Road Maintenance Unit.
Please contact the applicable Regional Coordinator by County to submit your application packet and fee. Email for the Reg. Coordinators are: (Coordinator’s)
Region 1 (919) 622-9181 / Region 2 (252) 904-1760 / Region 3 (910) 639-3564North Carolina Dept. of Transportation
1701 W. 5th St.
Washington, NC 27889
Att. Stephen Gardner
/ North Carolina Dept. of Transportation
4009 District Drive
Raleigh NC, 27607
Att. Edward Love
/ North Carolina Dept. of Transportation
902 N. Sandhills Blvd.
Aberdeen, NC 28315
Att. Johnny Ransdell
Counties: Beaufort, Camden, Carteret, Chowan, Craven, Currituck, Dare, Gates, Greene, Hyde, Jones, Lenoir, Martin, Onslow, Pamlico, Pasquotank, Pender Perquimans, Pitt, Tyrrell, Washington / Counties: Bertie, Edgecombe, Franklin, Halifax, Hertford, Johnston, Nash, Northampton, Vance, Wake, Warren, Wayne, Wilson / Counties: Bladen, Brunswick, Columbus, Cumberland, Duplin, Harnett, New Hanover, Hoke, Lee, Moore, Richmond, Robeson, Scotland, Sampson
Region 4 (919) 427-1510 / Region5 (704) 723-1424 / Region 6 (828) 817-0290
North Carolina Dept. of Transportation
1584 Yanceyville St.
Greensboro, NC 27415-4996
Att. Eric Thrasher
/ North Carolina Dept. of Transportation
130 So. Sutherland,
Monroe, NC 28112
Att. Mason Thompson
/ North Carolina Dept. of Transportation
3931 NC 226 S
Marion, NC , 28752
Att. Mark Thomas
Counties: Alamance, Alleghany, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Granville, Guilford, Montgomery, Orange, Person, Randolph, Rockingham, Rowan, Stokes, Surry, Yadkin / Counties: Alexander, Anson, Ashe, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Stanly, Union, Wilkes / Counties: Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Yancey
A proposed sign location must meet all applicable criteria at the time an application is submitted.
The sign owner must place temporary stakes at the exact proposed sign location prior to submitting the application. The sign owner is responsible for determining the location of state rights of way.
In the spaces showing vertical columns beginning with the property owner, the required information should be shown beginning in the first column on the left. The size of the sign must be shown in units of feet to the nearest one-half foot in decimal form (example 30.5’ X 12.5’ = 381.25 sq. ft.) Show the area of the sign to the nearest whole square foot (example 381 sq. ft.). The size of the advertising shall include any border and trim but exclude the base or apron, embellishments, supports, and other structural members. The area shall be calculated by measuring the outside dimensions of face, excluding any apron, embellishments, or extended advertising space. The maximum size limitations shall apply to each side of a sign structure and the signs may be placed back-to-back, side-by-side (structurally tied together), or in V-type construction with no more than two displays to each facing. Check the corresponding block that indicates if the sign is lighted, the type of display, and whether it will have automatic changeable facing.
For sign structure height, show proposed height as measured vertically from the adjacent edge of pavement of the main traveled way (maximum height of 50 feet). Upon construction of the sign, the sign owner is responsible for notifying the district office so a final inspection can be made.
PERMIT FEES: A check payable to the NC Department of Transportation in the amount of $120.00 for each sign structure application must accompany the completed application and attachments as noted on the front of the application. An annual renewal fee of $60.00 for each sign is due on April 15. A directional sign application fee is $60 and the annual renewal fee is $30. The sign owner will receive an invoice for renewals.
A copy of the approved application or a letter of denial, for a new sign structure will be returned to the applicant within thirty (30) days of receipt in most cases. In case of rejection, the complete file will be returned to the applicant within approximately ten (10) days stating the reason for rejection.
An off-premise advertising sign must not be erected until a permit is issued. A Stop Work Order will be issued for illegally erected advertising.
The identification tag (permit emblem) that will be issued at the time of permit approval must be attached to the sign, visible and readable from the main-traveled way within thirty (30) days after the sign is erected. The sign shall also bear the sign owner’s name.
This permit does not grant permission for removal or trimming of shrubs or trees on the highway right of way. Violators will be prosecuted and the sign permit will be revoked. Applications for Selective Vegetation Removal Permits may be obtained from the appropriate division or county roadside environmental engineer, two years after the acceptance date of this application.
It is unlawful to violate the control of access on interstate, freeway or other controlled access facilities. Violators may be prosecuted in these instances and the sign permit will be revoked. On controlled access facilities, sign owners must perform necessary maintenance of outdoor advertising structures from private property.
REVOCATION OF PERMIT: The permit is subject to all applicable rules and regulations and is subject to revocation for violations thereof.
The Sign Owner/Permit Holder is responsible for constructing and maintaining outdoor advertising in accordance with the Outdoor Advertising Control Act and rules outlined in N.C. Admin. Code t. 19A, s.2E.0200.
Failure to construct the outdoor advertising structure except all sign faces within 180 days from the date of issuance of the outdoor advertising permit will result in revocation of the permit.
UNLAWFUL ADVERTISING: Should any outdoor advertising be erected or maintained in violation of “The Outdoor Advertising Control Act,” the Department of Transportation or its agents shall give thirty (30) days’ notice, with the exception of the owner of unlawful portable outdoor advertising for which the Department of Transportation shall give five (5) days’ notice to remove the outdoor advertising or make it conform to the provisions of this article. The Department of Transportation or its agents shall have the right to remove the illegal outdoor advertising thirty (30) days after notification or five (5) days for owners of portable outdoor advertising at the expense of the owner if owner fails to act.