Application Submittal Checklist for an
Planning & Development Department
Planning Division
200 S. Willow St.
P.O. Box 1727
Jackson, WY 83001
ph: (307) 733-3959
fax: (307) 739-9208
ADJ Checklist 1 Effective 01/01/2015
APPLICABILITY. This checklist should be used when submitting an application for an Administrative Adjustment. The purpose of
an administrative adjustment is to provide the Planning Director the ability to allow minor variations to certain requirements and
numerical standards in the LDRs when public review is not needed to ensure the protection afforded the community is upheld.
When is an Administrative Adjustment required?
of an administrative adjustment is required for any use, physical development, development option, or subdivision
proposal that fails to meet an applicable LDR standard, where the strict application of that standard would inadvertently impede
the applicant
’s ability to realize the community’s desired future character for the property. An administrative adjustment request
is most often reviewed in conjunction with the application for the use, physical development, development option or subdivision
requiring the adjustment.
Do I need a Pre-Application Conference first?
A Pre-
Application Conference is not required prior to submittal of an administrative adjustment, unless the request is submitted
in conjunction with another application that does require a Pre-Application conference. An applicant may request a Pre-
Application meeting to discuss the requirements and applicable regulations with Planning Staff. This is encouraged for applicants
who are unfamiliar with the regulations and the planning process. If a Pre-Application Conference is held, this checklist may be
modified by staff to reflect the specifics of your project.
The application shall include a narrative statement addressing each of the applicable Findings for
Approval, found in Section 8.8.1, Administrative Adjustment.
An administrative adjustment shall be approved upon finding the application:
1. Complies with the applicability standards of this Section;
2. Either:
a. Compensates for some unusual constraint of the site or proposal that is not shared by landowners generally, or
b. Better protects natural and scenic resources, or
c. Better supports the purpose of the zone;
3. Is consistent with the purpose of the zone and the desired future character for the area described in
4. the Comprehensive Plan;
5. Will not pose a danger to the public health or safety; and
6. The site is not subject to a series of incremental administrative adjustments that circumvent the purpose of this Section.
Adjustment Requested. Identify the provision of the LDRs from which you are seeking relief.
Narrative description of the proposal. Briefly describe the proposed use, physical development, development option or
subdivision requiring the adjustment.
An administrative adjustment request will be reviewed in conjunction with an application for the use, physical development,
development option or subdivision requiring the adjustment. Demonstration of compliance with applicable LDR standards will be
addressed primarily through the application for the use, physical development, development option or subdivision.
Planning & Development Department
Planning Division
200 S. Willow St.
P.O. Box 1727
Jackson, WY 83001
ph: (307) 733-3959
fax: (307) 739-9208
Planning Permit Application 1 Effective 01/01/2015
For Office Use Only
Fees Paid
Check # Credit Card Cash
Application #s
Mailing Address:
Mailing Address:
Owner Applicant/Agent
TYPE OF APPLICATION. Please check all that apply; see Fee Schedule for applicable fees.
Use Permit
Physical Development
Basic Use
Conditional Use
Special Use
Sketch Plan
Development Plan
Formal Interpretation
Zoning Compliance Verification
Relief from the LDRs
Development Option/Subdivision
Amendments to the LDRs
Administrative Adjustment
Beneficial Use Determination
Appeal of an Admin. Decision
Development Option Plan
Subdivision Plat
Boundary Adjustment (replat)
Boundary Adjustment (no plat)
LDR Text Amendment
Zoning Map Amendment
Planned Unit Development
Planning Permit Application 2 Effective 01/01/2015
PRE-SUBMITTAL STEPS. Pre-submittal steps, such as a pre-application conference, environmental analysis, or neighborhood
meeting, are required before application submittal for some application types. See Section 8.1.5, Summary of Procedures, for
requirements applicable to your application package. If a pre-submittal step is required, please provide the information below. If
you need assistance locating the project number or other information related to a pre-submittal step, contact the Planning
Department. If this application is amending a previous approval, indicate the original permit number.
Pre-application Conference #:
Environmental Analysis #:
Original Permit #:
Date of Neighborhood Meeting:
One copy of the application package (this form, plus all applicable attachments) should be
submitted to the Planning Department. The initial application submittal may occur electronically, but one hard copy of all
materials is required for an application to be found sufficient. Please ensure all submittal requirements are included. The Planning
Department will not hold or process incomplete applications. Partial or incomplete applications will be returned to the applicant.
Have you attached the following?
Application Fee. Fees are cumulative. Applications for multiple types of permits, or for multiple permits of the same
type, require multiple fees. See the currently adopted Fee Schedule in the Administrative Manual for more information.
Notarized Letter of Authorization.
A notarized letter of consent from the landowner is required if the applicant is not
the owner, or if an agent is applying on behalf of the landowner. If the owner is a partnership or corporation, proof that
the owner can sign on behalf of the partnership or corporation is also required. Please see the Letter of Authorization
template in the Administrative Manual for a sample.
Response to Submittal Checklist.
All applications require response to applicable review standards. These standards are
outlined on the Submittal Checklists for each application type. If a pre-
application conference is held, the Submittal
Checklists will be provided at the conference. If no pre-application conference is required, please see the Administrative
Manual for the applicable Checklists.
The checklist is intended as a reference to assist you in submitting a sufficient
application; submitting a copy of the checklist itself is not required.
The main component of any application is demonstration of compliance with all applicable Land Development Regulations (LDRs)
and Resolutions. The submittal
checklists are intended to identify applicable LDR standards and to outline the information that
must be submitted to sufficiently address compliance with those standards.
For some submittal components, minimum standards and formatting requirements have been established. Those are referenced
on the checklists where applicable. For all other submittal components, the applicant may choose to make use of narrative
statements, maps, drawings, plans and specifications, tables and/or calculations to best demonstrate compliance with a particular
Note: Information provided by the applicant or other review agencies during the planning process may identify other
requirements that were not evident at the time of application submittal or a Pre-Application Conference, if held. Staff may
request additional materials during review as needed to determine compliance with the LDRs.
Under penalty of perjury, I hereby certify that I have read this application and associated checklists and state that, to the best of
my knowledge, all
information submitted in this request is true and correct. I agree to comply with all county and state laws
relating to the subject matter of this application, and hereby authorize representatives of Teton County to enter upon the above-
mentioned property
during normal business hours, after making a reasonable effort to contact the owner/applicant prior to
Signature of Owner or Authorized Applicant/Agent
Name Printed
click to sign
click to edit