APPLICATION FOR INSPECTION OF A PUBLIC, PRIVATE OR RELIGIOUS SCHOOL

Name of School:
Location Address:
City:	State:	NC	Zip:
Contact Phone #:	Email:
Owner/Operator:
Mailing Address:
City	State:	Zip:
Contact Phone #:	Email:
Please specify the following:
Sewer:	Public/Municipal	On-site Wastewater System
Water:	Public/Municipal	Private Water Supply
If a well is provided, what is the year of construction?
Maximum number of students to be enrolled?
Is the facility new construction or remodeled?
Will meals be prepared on-site for students?

To assure that your application is processed in a timely manner, please submit a completed application including the following:

Zoning Permit

Site Plan showing all structures, property lines, wells, septic systems, dumpster, parking

Building floor plan drawn to scale showing all rooms including bathrooms, janitorial closets, gymnasiums, libraries, etc.

If preparing meals on-site, then also complete an application for a Food Establishment.

You will be responsible for obtaining approval from appropriate zoning and building inspection departments. Their numbers are included below to assist you.

ZONING	BUILDING INSPECTIONS

Shelby	704-484-6805	704-484-6805

Kings Mountain	704-734-4599	704-734-4599

Cleveland County	980-484-4975	980-484-4977

If your business will be located in any jurisdiction other than those listed above, please check with your city manager and/or town hall for permitting assistance.

Proposed opening date:
Date Application Submitted:
Applicant’s Signature:

APPLICATIONS CAN BE SUBMITTED IN PERSON OR BY MAILTO:

Cleveland County Permits Office

1333 Fallston Road

Shelby, NC 28150

Rev. 12/23