PLANNING PERMIT APPLICATION
Planning & Building Department
150 E Pearl Ave.
P.O. Box 1687
Jackson, WY 83001
ph: (307) 733-0440
www.townofjackson.com
For Office Use Only
Fees Paid
Date & Time Received
Application #s
PIDN:
Phone:
ZIP:
Phone:
ZIP:
PROJECT.
Name/Description:
Physical Address:
Lot, Subdivision:
PROPERTY OWNER.
Name:
Mailing Address:
E-mail:
APPLICANT/AGENT.
Name:
Mailing Address:
E-mail:
DESIGNATED PRIMARY CONTACT.
Property Owner
Applicant/Agent
TYPE OF APPLICATION. Please check all that apply; review the type of application at www.townofjackson/200/Planning
Use Permit
Physical Development
Interpretations
Basic Use
Conditional Use
Special Use
Sketch Plan
Development Plan
Design Review
Formal Interpretation
Zoning Compliance Verification
Relief from the LDRs
Subdivision/Development Option
Amendments to the LDRs
Administrative Adjustment
Variance
Beneficial Use Determination
Appeal of an Admin. Decision
Subdivision Plat
Boundary Adjustment (replat)
Boundary Adjustment (no plat)
Development Option Plan
LDR Text Amendment
Map Amendment
Miscellaneous
Other:
Environmental Analysis
Planning Permit Application 1
Effective 06/01/2019
Please note: Applications received after 3 PM will be processed the next business day.
PRE-SUBMITTAL STEPS. To see if pre-submittal steps apply to you, go to www.townofjackson.com/200/Planning and select
the relevant application type for requirements. Please submit all required pre-submittal steps with application.
Pre-application Conference #:
Original Permit #:
SUBMITTAL REQUIREMENTS. 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. Go to
www.townofjackson.com/200/Planning and select the relevant application type for submittal requirements.
Have you attached the following?
Application Fee. Fees are cumulative. Go to www.townofjackson.com/200/Planning and select the relevant
application type for the fees.
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. Please see the Letter of Authorization
template at www.townofjackson.com/DocumentCenter/View/102/Town-Fee-Schedule-PDF.
Response to Submittal Requirements. The submittal requirements can be found on the TOJ website for the
specific application. If a pre-application conference is required, the submittal requirements will be provided to
applicant at the conference. The submittal requirements are at www.townofjackson.com/200/Planning under the
relevant application type.
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 entering.
Signature of Property Owner or Authorized Applicant/Agent
Date
Name Printed
Title
Planning Permit Application 2 Effective 06/01/2019