Form DOA-SO-00025 "Application to Use Public Buildings and/or Grounds" - North Carolina

What Is Form DOA-SO-00025?

This is a legal form that was released by the North Carolina Department of Administration - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 14, 2019;
  • The latest edition provided by the North Carolina Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DOA-SO-00025 by clicking the link below or browse more documents and templates provided by the North Carolina Department of Administration.

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https://ncadmin.nc.gov/about-doa/divisions/facility-management/resources-and-forms
DOA-SO-00025 (Rev 2. 06/14/2019)
State of North Carolina, Department of Administration
APPLICATION TO USE PUBLIC BUILDINGS AND/OR GROUNDS
Please fill out electronic form, print or type. Sign accordingly once printed and ready for submission
Rules and regulations adopted by the Governor and Council of State govern use of public buildings and grounds (defined by G.S. 143-336) by any group of
whatever kind. Please complete Items 1 through 12 and submit one copy via mail, electronic mail (permitrequests@doa.nc.gov), or facsimile
(919-733-1430) to be received not less than 3 business days prior to the date of proposed use to Director, Facility Management Division, 1313 Mail
Service Center, Raleigh, North Carolina 27699-1313. Failure to comply with these regulations is punishable at the discretion of the Court under G.S.
143-345.1. Note that permits requests will not be considered more than one year in advance of the event date.
1. Public Building(s) and/or Grounds applied for:
2. Date of Application:
3. Date Desired:
4. Time Desired (limit of 4 hours):
5. Expected Attendance
From:
To:
6. Describe Intended Usage. Provide Goals, Objectives, or Purpose for this Permit Request:
Attach a copy of the REQUIRED Tent or Canopy
Will Tent or Canopy be used during the event? If Yes, what size:
approval.
Check if needed:
Electrical Power (voltage and amps):
Trash Cans
Recycle Bins
7. State Agency or Organization Making Request and Secretary/Executive involved if applicable:
Phone:
Address:
Fax:
:
Email Address
8. Contact Person accepting Responsibility for Event:
Phone:
Address:
Fax:
Email Address:
9. Give requested information about expected active participants (speakers, leaders, etc.) Attach separate sheet, if necessary.
Name
Address
Phone
10. Use separate sheet to list names, titles, and addresses of all officers and board members of organization, corporation, or group.
12: I have read and understand the regulations listed on the reverse
11. Applicant Signature (print name and sign):
side of this form. Responsible Person Signature (print name and sign):
**** THE SECTION BELOW IS TO BE COMPLETED BY INTERNAL REVIEW STAFF ****
Security Required?
Yes
No
If Yes, Security provided by
State Capitol Police
City of Raleigh
Other
Number of Officers Needed:
Recommend Approval
Duration Officers Needed:
Recommend Disapproval
Approved by Chief, State Capitol Police
Date
Permit Number:
Permit Approved
Permit Denied
Approved by Director,
Date
Facility Management Division
https://ncadmin.nc.gov/about-doa/divisions/facility-management/resources-and-forms
DOA-SO-00025 (Rev 2. 06/14/2019)
State of North Carolina, Department of Administration
APPLICATION TO USE PUBLIC BUILDINGS AND/OR GROUNDS
Please fill out electronic form, print or type. Sign accordingly once printed and ready for submission
Rules and regulations adopted by the Governor and Council of State govern use of public buildings and grounds (defined by G.S. 143-336) by any group of
whatever kind. Please complete Items 1 through 12 and submit one copy via mail, electronic mail (permitrequests@doa.nc.gov), or facsimile
(919-733-1430) to be received not less than 3 business days prior to the date of proposed use to Director, Facility Management Division, 1313 Mail
Service Center, Raleigh, North Carolina 27699-1313. Failure to comply with these regulations is punishable at the discretion of the Court under G.S.
143-345.1. Note that permits requests will not be considered more than one year in advance of the event date.
1. Public Building(s) and/or Grounds applied for:
2. Date of Application:
3. Date Desired:
4. Time Desired (limit of 4 hours):
5. Expected Attendance
From:
To:
6. Describe Intended Usage. Provide Goals, Objectives, or Purpose for this Permit Request:
Attach a copy of the REQUIRED Tent or Canopy
Will Tent or Canopy be used during the event? If Yes, what size:
approval.
Check if needed:
Electrical Power (voltage and amps):
Trash Cans
Recycle Bins
7. State Agency or Organization Making Request and Secretary/Executive involved if applicable:
Phone:
Address:
Fax:
:
Email Address
8. Contact Person accepting Responsibility for Event:
Phone:
Address:
Fax:
Email Address:
9. Give requested information about expected active participants (speakers, leaders, etc.) Attach separate sheet, if necessary.
Name
Address
Phone
10. Use separate sheet to list names, titles, and addresses of all officers and board members of organization, corporation, or group.
12: I have read and understand the regulations listed on the reverse
11. Applicant Signature (print name and sign):
side of this form. Responsible Person Signature (print name and sign):
**** THE SECTION BELOW IS TO BE COMPLETED BY INTERNAL REVIEW STAFF ****
Security Required?
Yes
No
If Yes, Security provided by
State Capitol Police
City of Raleigh
Other
Number of Officers Needed:
Recommend Approval
Duration Officers Needed:
Recommend Disapproval
Approved by Chief, State Capitol Police
Date
Permit Number:
Permit Approved
Permit Denied
Approved by Director,
Date
Facility Management Division
INSTRUCTIONS AND REGULATIONS
1.
Permits ordinarily will be issued for a maximum of four (4) hours, including setup and cleanup. Requests for an
extended time period may be granted upon fully documented need. Requests will not be considered more than one
year in advance of the event date. The Department of Administration reserves the ability to reasonably adjust the time
or location of permitted uses to accommodate government operations, public order and safety.
2.
Permit holder is responsible for the removal of all trash generated from activity conducted on state grounds.
3.
The following items and activities are prohibited, and any violation will result in an immediate revocation of the permit
and removal from the property:
a.
The possession of any firearm or other dangerous weapon of any kind, including but not limited to any bowie
knife, dirk, dagger, sling shot, loaded cane, metallic knuckles, razor, shuriken, stun gun, or other deadly
weapon of like kind.
b.
Stick-holding placards.
c.
The use of unmanned aircraft systems (drones).
d.
Hazardous, flammable, or combustible liquids or materials.
e.
Any mask, hood, or other device whereby a substantial portion of the face is hidden or covered unless
otherwise permitted by law.
f.
Failing to comply with any terms or conditions place on a permit.
g.
The failure to comply during an event with any lawful directive of a law enforcement officer, or with any
lawfully posted public sign, direction or instruction.
h.
Climbing, during and event, upon any tree, or any wall, fence, shelter, fountain, statue, or any other structure
not specifically intended for climbing purposes.
i.
Rendering any part of an event venue dangerous, unsafe or unsuitable for use by others.
j.
Closing any street or public right-of-way during an event or using any street or right-of-way in a manner that
obstructs vehicular or pedestrian passage during an event, without first obtaining a street closing permit.
k.
Holding, carrying, displaying or using any prohibited item as defined herein within the area where a permitted
event is taking place, without prior written consent.
l.
Throwing or propelling objects of a potentially dangerous nature during an event, including but not limited to
rocks, bottles, sticks, staffs, glass objects or cans.
m.
Engaging in a course of conduct or committing any act that endangers the public welfare or safety of others
during an event.
n.
Damaging landscaping, planting, improvements, equipment or structures located on state property where an
event is being held.
4.
Events held during work hours (7:30 a.m. to 5:30 p.m. Monday through Friday) affect employees in nearby offices.
Public address (PA) systems to amplify voice are permitted, but the sound should not be audible more than 100 feet
from the speaker location.
5.
Electrical outlets are generally available but are the permit holder’s responsibility to confirm in advance of the event.
Water hook-ups are not provided.
6.
Regardless of which site is authorized by permit to use, do not block entrances, exits or sidewalks. These must
always be available for pedestrians and visitors to the building.
7.
Inside of public buildings, utilization of public corridors must ensure that no entrance, exit, restroom or office doors
are blocked and that handicapped accessibility is not impeded. Guests must be mindful of their impact on employees
working in these facilities.
DOA / Facility Management Division
Revision 2. 06/14/2019
INSTRUCTIONS AND REGULATIONS CONTINUED
8.
VEHICLE USE AND PARKING:
a.
Parking is not permitted on the State Capitol grounds, Bicentennial Mall and Halifax Mall.
Use of vehicles at permitted sites is restricted to loading and unloading purposes. Violation of terms
may result in permit cancellation and future denials.
b.
Vehicles are only permitted in the designated area of the Halifax Mall between the Education and Revenue
buildings for loading and unloading purposes. Lightweight vehicles such as a golf cart may be used to
transport materials and supplies from this area to the event area.
c.
Visitor parking is available at the corner of Wilmington and Jones streets.
9.
RULES SPECIFIC TO THE STATE CAPITOL BUILDING:
a.
In addition to submitting this permit application, all requests for the State Capitol must notify the
State Capitol Historic Site office
at 919-733-4993 and ask for its permit request form.
This Application to use Public Buildings and/or Grounds is only for a request to use the grounds
and does not include access to the State Capitol.
b.
Vehicles are only permitted in the driveway loop on the north side of the Capitol Building for loading
and unloading purposes. Parking on sidewalks is expressly prohibited.
10.
USE OF TENTS AND CANOPIES:
a.
Tents and membrane structures with an area in excess of 700 square feet and canopies in excess of
1800 square feet shall not be erected, operated or maintained for any purpose without first obtaining
a permit and approval from the State Construction Office.
b.
Specific rules regarding erection of tents and canopies are available from the State Construction Office,
919-807-4100. Ask for a Code Consultant if you have questions. The authorization request form is
available online at Facility Management Division/Forms
c.
Tent/canopy approvals from the State Construction Office must be submitted no later than 36 hours before
installation. Failure to submit tent/canopy approvals may result in cancellation of permit.
d.
All tents/canopies used must be weighted and not stake driven. The structure will be inspected by the
appropriate fire code official on the day it is constructed. Any structure that is in violation of NC Fire Code or
not specifically approved by permit must be removed. If not removed, the event permit will be terminated.
e.
State Construction Office mailing address is 1307 Mail Service Center, Raleigh, NC 27699-1307 (Courier Number
56-02-01). Plans may be delivered to its offices located in the Education Building, 301 N. Wilmington St., Suite
450, Raleigh, or faxed to 919-807-4110.
DOA / Facility Management Division
Revision 2. 06/14/2019
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