JACKSON COUNTY OFFICE OF PERMITTING & CODE ENFORCEMENT
Land Development Application
Sylva Office: 401 Grindstaff Cove Rd, Suite 145, Phone: 828-586-7560 / Fax: 828-586-7563
Cashiers Office: 357 Frank Allen Road, Phone: 828-745-6850 / Fax: 828-745-6867
FOR OFFICE USE
Site’s Physical Address: Parcel/Lot Size
Subdivision Name: Lot Number: Township: Municipality:
Fire District: High Quality Water: Stream Classification:
Is This Site Within: Watershed Floodplain Protected Ridge County Zoning District
For Office Use: Fee Paid? Yes (Paid) Not Required Application number:
OWNER/APPLICANT INFORMATION
PIN: DATE:
Property Owner’s Name (as listed on tax parcel): Local Contact’s / Agent’s Name:
Property Owner’s Mailing Address: Local Contact’s/ Agent’s Mailing Address:
Property Owner’s Phone Number: Local Contact’s/ Agent’s Phone Number:
Property Owner’s E-MAIL Address: Local Contact’s/ Agent’s E-MAIL Address:
Contractor’s Name (if known): Contractor’s Phone (if known):
PROJECT/SITE DATA
Improvement Description:
Acreage of Disturbed Area:
Building Size:
Methods to be used for Erosion Control:
Utilities: TWSA Well Septic Other (Please specify )
Specific Directions to Site:
ADDITION/REMODEL NEW EXISTING
SUBDIVISION DEVELOPMENT NEW EXISTING
OFF PREMISE SIGN NEW EXISTING
MOBILE HOME PARKS NEW EXISTING
COUNTY ZONING DISTRICT NEW EXISTING
MISC. GRADING
CERTIFICATION
Approved to proceed with permitting process when signed by Permit Center staff. Date
Silt Fence Berm/Diversions Temp. Gravel Construction Entrance
1/2 or less acres E/C Plan has been filed.
Seeding/Vegetation within 10 days of final grading Other:
Gate Code:
I hereby certify that the information given above, to the best of my knowledge, is true and correct. I am aware that the State and/or
County staff can and will conduct periodic inspections of this project to ensure compliance.
I acknowledge that I have been informed of land use regulations subject to my property or development.
I understand that I must contact the Permitting Office at least one business day prior to any work commencing.
The signature below signifies full responsibility for all land disturbing activities on site.
Owner’s/Agent’s Signature: Date:
You may submit a completed, signed copy of this application to our office in person, by fax, or e-mail to
jcpermitcenter@jacksonnc.org. Fees may be required.
City
State
Zip
City
State
Zip
Power Provider:
SINGLE FAMILY RESIDENCE NEW EXISTING
MULTI FAMILY DEVELOPMENT NEW EXISTING
MANUFACTURED HOME NEW EXISTING
ACCESSORY STRUCTURE NEW EXISTING
RETAIL/OFFICE BUILDING NEW EXISTING
INDUSTRIAL DEVELOPMENT NEW EXISTING
HEAVY COMMERCIAL NEW EXISTING
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