JACKSON COUNTY PERMITTING & CODE ENFORCEMENT
Manufactured Home Placement 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
LIEN AGENT REQUIRED? NO YES
LIEN ENTRY NUMBER: _________________________
PROPERTY PIN: ______________________________ IN AN EXISTING M/H PARK?* NO YES
Permits will not be issued without Property PIN and proof of an approved method of sewage disposal.
NAME: ____________________________________________ PHONE: _____________________________
ADDRESS: _______________________________________________________________________________
CITY: _________________________________________ STATE: ___________ ZIP: _________________
E-MAIL ADDRESS: ________________________________________________________________________
HOME TYPE: Singlewide Doublewide Triplewide Camper/RV Number of Bedrooms: _____
LAND USE: Residential Commercial (Must have NC Licensed Subcontractors)
CONTRACTORS
NC LIC #
PHONE
MH SETUP:
ELECTRIC:
PLUMBING:
MECHANICAL:
*If you are installing more than one manufactured home you must discuss your plans with us prior to submittal of
this application. You may be required to submit a site plan and fill out an Application for Construction of a
Manufactured Home Park.
DETAILED DIRECTIONS TO SITE (IF POSSIBLE, PLEASE INCLUDE A 911 ADDRESS)
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_______________________________________________________________________________________________________________________________________
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POWER PROVIDER: _________________________ JOB # (if Duke Energy): ________________________
I hereby certify that all information in this application is correct and all work will comply with the State Building
Code and all other applicable State and local laws and ordinances and regulations. The inspection Department will
be notified of any changes in the approved plans and specifications for the project permitted herein.
SIGNATURE: _________________________________________ DATE: ___________________________
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signature
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JACKSON COUNTY 9-1-1 OFFICE JACKSON COUNTY, NORTH CAROLINA
Phone: (828) 586-7537 / Wanda Hall ADDRESS REQUEST FORM
(828) 586-7534 / Zeb Holland
Mail to: 401 Grindstaff Cove Rd.
Sylva, NC 28779
Fax to: (828) 586-7573 or
Email: zebholland@jacksonnc.org Date of Application: _________________
The following information is required in order to assign you a permanent house number and road name. This
address is necessary for Jackson County to provide you, the homeowner, with adequate emergency service when
a 9-1-1 call is made. Your address will be assigned as soon as possible after your request is made. (The driveway
must be cut in on the property before the address can be generated). This form must be filled out if you are
building a new home or placing a mobile home on your property. Leave this form at the Building Permit office.
The assigned address must be posted on your home or at your driveway before a Certificate of Occupancy can be
issued.
Homeowners Name: _____________________________ Telephone: ______________________
Contractor’s Name: _____________________________ Telephone: _______________________
Road Name: ___________________________________ PIN #___________________________
Parcel Identification Number
Building Permit # ______________________________ Lot # if applicable:________________
Directions to building site: _________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Name of nearest neighbor: _________________________________________________________
Description of new home: (example: 2-story gray house) ________________________________
Attach a drawing of the proposed location of the structure and driveway. You can create this drawing
on the Jackson County Parcel Viewer. Go to the following link: gis.jacksonnc.org/rpv. Check the
disclaimer box and click OK. Click map layers on top right green bar, click aerials, then 2019 aerials.
Then, type the PIN number or owner name (formatted "last name, first name") in the box in the top
left corner and hit enter to bring up your parcel. You should see your parcel highlighted (click on it if
it’s not). You can click and drag the map to move around or use your mouse scroll to zoom in and out.
To draw on the map, click on the button with the wrench in the upper right corner, then click "Draw".
You can place a point on the map where the structure will be and use one of the line options to draw
the driveway (freehand polyline works best; just click and drag along the map to draw). Afterwards,
you can click on the printer button on the green bar at top to download your parcel drawing to a PDF.
Once this file is downloaded, you can print it as normal (through Adobe or your internet browser).
If this home is not to be your permanent full-time residence, please list an out of town mailing
address and telephone number where you can be reached.
Mailing Address: ___________________________________ Telephone: ___________________
___________________________________
(FOR OFFICE USE ONLY) NEW HOME ADDRESS: ________________________________