Fillable STRUCTURE TO BE PLACED BY WYOMING LICENSED LAND (Teton County Wyoming Government)

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STRUCTURE TO BE PLACED BY WYOMING LICENSED LAND (Teton County Wyoming Government)

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BROWSE TETON COUNTY WYOMING GOVERNMENT (WY) FORMS

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Certificate of Placement Effective 01/01/2020
CERTIFICATE OF PLACEMENT
Planning & Development Department – Building Division
STRUCTURE TO BE
PLACED BY
WYOMING LICENSED
LAND SURVEYOR
200 S. Willow St.
P.O. Box 1727
Jackson, WY 83001
ph: (307) 733-7030
www.tetoncountywy.gov
BDR/BDC NUMBER:
PROPERTY OWNER:
CONTRACTOR:
ARCHITECT:
SURVEYOR:
DATE OF SURVEY:
Identify the date of Planning/Building approval used for this Certificate:
The location of the proposed foundation was determined by a survey of:
POINTS ON BUILDING FOOTERS
THE LOCATION OF SET-IN-PLACE FOUNDATION FORMS
The points as located for the proposed foundation walls are in agreement with the location of the foundation as shown on the approved site plan
and building permit special conditions of approval. (small deviations within normal foundation tolerances are expected.)
YES. No further information is required.
NO. Please explain:
If foundation placement does not match the approved site plan and building permit special conditions of approval, additional
surveyor information is required. WORK CANNOT PROCEED WITHOUT REVIEW AND APPROVAL BY TETON COUNTY PLANNING
STAFF. The surveyor should prepare and attach a legible sketch of the site showing the following:
Approved location of building
Approved setbacks
Surveyed location of foundation as found
Signature of Planner Approving New Location
Date
Surveyor Seal – signed and dated
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STRUCTURE TO BE PLACED BY WYOMING LICENSED LAND (Teton County Wyoming Government)

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Completed 18 July 2020

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