HPC_CoA_Application_202401
Page 1 of 1 HPC_CoA_Application_202401.docx
Certificate of Appropriateness Application City of Prattville, Planning & Development Department 102 W Main Street Prattville, AL 36067 (334) 595-0500 / planning@prattvilleal.gov
Address or Location of Property: ______________________________________________________________________________
Name of Applicant(s): _________________________________________ Phone: __________________________________
Address: ____________________________________________________ Email: __________________________________
Name of Owner(s): ____________________________________________ Phone: __________________________________
Address: ____________________________________________________ Email: __________________________________
The applicant will be the point of contact for all communication with city staff
Describe clearly and in detail the proposed work:
*Attached additional pages if more space is needed.
All items must be initialed as included or understood or “N/A” if not applicable:
_____ Proof of ownership and executed Designation of Agent form if applicant is not owner
_____ Scaled site layout including all existing structures, fences, walkways, driveways, signs, lighting, etc.
_____ Scaled drawings, including elevations showing the proposed changes to the building’s exterior architectural features
_____ Samples of proposed materials to be used (photographs may be substituted for actual materials in some cases – consult staff)
_____ Photographs of the existing structure taken from several views of the structure and site
_____ If demolition, complete additional HPC CoA Demolition Supplement
_____ Any additional materials or documentation that will assist the Historic Preservation Commission in the review (inadequate
information, explanations, samples, drawings, photographs, etc, may result in a postponement of the Commission’s decision or a denial of
your request)
_____ Application Fee
_____ I agree to allow the City to place a sign or signs on this property notifying the public of this request
_____ I understand that a Certificate of Appropriateness issued by the HPC is NOT a building permit nor authorization to begin work.
Building permits must be obtained from the Building Department
_____ Applicant or authorized representative of the applicant must attend the public hearing to support the application
_____ I have reviewed the current Historic District Design Guidelines and I understand that the HPC will use them when making their
decision
*Deadline to apply for next meeting: ______ / ______ / ______ *Date of next available meeting: ______ / ______ / ______
**Each application will be considered on its own merit. While the Historic Preservation Commission may consider past actions when
making decisions on a CoA, it is not held by those decisions when considering new applications that may appear similar in character.
I have read the above statements and warrant in good faith that I understand and will comply, and that the information
submitted is true and correct. I acknowledge that submitting incorrect or incomplete information that results in delays
is the sole responsibility of the applicant.
Applicant Signature: ________________________________________________________ Date: ______ / ______ / 20_______
STATE OF ALABAMA COUNTY OF _____________________________
I, _________________________________________________, a Notary Public in and for said State at Large, hereby certify that _________________
_______________________________________________, whose name is signed to the foregoing document, and
______ Who is known to me, or ______ Whose identity I proved on the basis of Driver’s license / passport / military ID / other
and that being informed of the contents of the document, he/she, as such officer and with full authority, executed the same voluntarily on the day the
same bears date. Given under my hand and official seal this the _________ day of _______________________________, 20______.
_____________________________________________, Notary Public My Commission Expires: __________________________
Yes
No
Is this property in a Special Flood Hazard Area?* *approximately 40% of the Prattville Historic District is in a Special Flood Hazard Area (floodplain). For more information, please contact the Planning Department