Please provide a brief description of work to be completed:
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FLOOD PLAIN: See County Floodplain Management Resolution and Flood Insurance Rate Maps (FIRMs), which are available on the
County GIS Map Server https://maps.greenwoodmap.com/tetonwy/mapserver/
What is the property’s Flood Zone Designation? Check all that apply:
A AE AO X Other (please identify):
NOTICE: This permit becomes null and void if work authorized by its issuance is not commenced within 180 days, or work
is suspended or abandoned for a period of 180 days at any time after work has commenced. .
The granting of this permit does not
g
ive authority to violate or cancel the provisions of any state or local law regulating
construction or the performance thereof.
I certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this work will be complied with whether specified herein or not
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Signature of Contractor or Owner/Builder Date
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Print Name Title
For Office Use
Only
Inspections Date Inspector Initials Notes
Rough-In
Final