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Instructions for Filing an Application for a Special Use Permit

    1. The petitioner for a special use permit must complete the application in full. The application will not be processed unless all information requested is provided.
    2. There is a $125.00 fee for each special use permit application.
    3. An accurate plot plan of the property in question must accompany the application. The plot must be drawn by a registered land surveyor, licensed engineer or licensed architect. The drawing shall include:
        • dimensions of the entire lot;
        • location and dimension of all existing structures (principal and accessory) including number of stories and gross floor area;
        • location and dimension of all existing driveway(s) and pedestrian improvements on site and on adjoining properties within ten (10) feet of the subject lot;
        • location and dimension of all existing parking areas including the total number of spaces. Where the subject use is to share a common parking area with other existing or future uses, indicate the allocation of spaces devoted or reserved to each separate use;
        • location and dimension of required bufferyards;
        • minimum building line (R/W) MBL.
        • any other site graphic or written information in support of the request at the option of the applicant;
        • eighteen (18) paper copies of the plan; 8.5" x 11"minimum to 30" x 42" maximum; scale of 1" = 20' or larger;
        • location map drawn to scale of not less than 1" = 1000'.


NOTE: The Board of Adjustment reserves the right to require additional information where such submission is necessary to insure compliance with applicable criteria in the individual case.


  1. The petitioner shall submit to the Department of Planning and Development a list of all adjoining property owners within one hundred (100 ) feet of the property which is the subject of the action, with the current mailing address of each. These adjoining property owners will be notified of the proposed request.
  2. The applicant shall submit the following with the application and the plot plan:
    a) Tax Map
    b) Tax Card
  3. The application must be signed by those who are authorized to appeal to the Board of Adjustment for a special use permit.
  4. In order to be considered by the Board of Adjustment, applications must be submitted to the Department of Planning and Development no later than the fifteenth (15th) day of the month prior to the next scheduled board meeting. For more information and assistance, call the City of Washington Department of Planning and Development at (252) 975-9384.

These are minimal submission requirements.
The Board of Adjustment may require additional information.
You are encouraged to submit copies of available property surveys, recorded easements, etc..

Application for Special Use Permit

Page 1   (Applicant Information)
Page 2   (Applicant Responses to General Requirements, pt. 1)
Page 3   (Applicant Responses to General Requirements, pt. 2)
Page 4   (Property Owners Within 100 Feet)
Page 5   (Owner Authorization for Non-Owner Application)

Applicant should print out and complete all five (5) pages.