Building Development Center
Master Application
Page 2 of 2
BILLING OF INVOICES
The fee charged at the time of application covers base hours listed on the fee schedule. When base hours by a Department
are used, a monthly billing invoice is generated at the hourly rate listed on the fee schedule. Should review of the project
exceed the base hours allotted, billing invoices shall be mailed to: Owner Applicant Point of Contact
PROPERTY OWNER (additional property owner sheet can be obtained online at www.thurstoncountybdc.com)
Property Owner Name _______________________________________________________________________________
Mailing Address __________________________________City__________________State_______Zip Code__________
Phone (_____)______________________Cell (______)_____________________Fax (______)_____________________
EMAIL __________________________________________________________________________________________
Communication from staff provided by Email? YES NO
Property Owner Signature*________________________________________________Date______________________
APPLICANT
Applicant Name ____________________________________________________________________________________
Mailing Address __________________________________City__________________State_______Zip Code__________
Phone (_____)______________________Cell (______)_____________________Fax (______)_____________________
EMAIL __________________________________________________________________________________________
Communication from staff provided by Email? YES NO
Signature*_______________________________________________________________Date_____________________
POINT OF CONTACT (Person receiving all County correspondence)
Name ____________________________________________________________________________________________
Mailing Address __________________________________City__________________State_______Zip Code__________
Phone (_____)______________________Cell (______)_____________________Fax (______)_____________________
EMAIL __________________________________________________________________________________________
Communication from staff provided by Email? YES NO
Signature*_______________________________________________________________Date_____________________
*DISCLAIMER
Application is hereby made for a permit(s) to authorize the activities described herein. I certify that I am familiar with the information
contained in the application package and that to the best of my knowledge and belief, such information is true, complete, and accurate.
I further certify that I possess the authority to undertake the proposed activities. I hereby grant to the agencies to which this
application is made or forwarded, the right to enter the above-described location to inspect the proposed, in-progress or completed
work. I agree to start work only after all necessary permits/approvals have been received.
Revised 03.11.19
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
