DEVELOPMENT PERMIT APPLICATION
Quad Cities Planning & Development
706-367-5011
Serving the Cities of Arcade, Jefferson, Talmo
**MUST BE FILLED OUT COMPLETELY AND ALL REQUIRED SUBMITTALS ATTACHED IN ORDER TO BE PROCESSED**
Property/Site Address: ____________________________________________ City: ____________________
Subdivision and Lot: _______________________________________________________________________
Tax Map / Parcel: _____________________ Zoning: _________ Proposed Use: ________________________
Total Project Acreage: ___________________ Total Disturbed Acreage: _________________
Sewer / __ City __ County
Septic (provide copy of permit)
Water / __City __ County
Property Owner Name: _______________________________ Phone: _______________ Fax: ___________
Owner Address: _____________________________________ City: ____________________ Zip: ________
Email: _____________________________________
Developer Name: _____________________________________ Phone: _______________ Fax: __________
Developer Address: ____________________________________ City: ____________________ Zip: _______
Developer Contact Name: _____________________________________ Contact Number: ________________
Email: ____________________________________
Project Engineer Business Name: __________________________ Phone: _____________ Fax: ___________
Project Engineer Address: ________________________________ City: ____________________ Zip: _______
Project Engineer Contact Name: ________________________________ Contact Number: ________________
Email: ___________________________________
Soil Erosion 24-hour Contact Name: ___________________________ Contact Number: _________________
Required Items For Initial Submittal:
□ Eleven (11) complete sets of plans;
□ Soil Erosion and Sedimentation Control Permit Application; (Attached)
□ Soil Erosion and Sedimentation Control check list;
□ Soil Erosion and Sedimentation Control Educational Contribution of $40.00 made payable to Oconee River
Soil and Conservation District. (See Attached Form);
□ Development Review Fee Sheet and fee (Note: additional fee requirements are applicable, but not due until
issuance of permit). (See Attached Form);
□ Jackson County E-911 Street Name Request Form;
□ Three (3) Hydrology Reports;
□ Copy of Notice of Intent filed with the State;
□ Copy of receipt for payment of State NPDES fees;
□ Copy of GDOT driveway(s) permit, if required, or completed Quad Cities driveway application;
□ Is the project located in a Historical District? If so, provide copy of Certificate of Appropriateness.
I hereby make application for a development permit to perform work as described above, and if the permit is granted I agree to
comply with all applicable and pertinent governing regulations and ordinances, pertaining to and in accordance with any plans
submitted. I understand failure to comply with these regulations could be grounds for revocation of the permit.
Applicant Signature: _________________________________________________ Date: __________________
SOIL EROSION AND SEDIMENTATION CONTROL
PERMIT APPLICATION
City of Jefferson/Arcade/Talmo
City of Jefferson Department of Planning and Development
147 Athens Street
Jefferson, GA 30549
Phone: 706/367-5011
Fax: 706/367-5134
Name of Project: __________________________________________
Subdivision: _____________________________________________
Street Address: ___________________________________________
Tax Map: ______ Parcel: _____ Existing Buildings?: Yes ____ No ____
Proposed Use: ____________________________________________
Applicant Name: __________________________________________
Address: ________________________________________________
City/State/Zip: ___________________________________________
Phone Number: ___________________________________________
Contact Person: ___________________________________________
Phone Number: ___________________________________________
Owner’s Name: ___________________________________________
Address: ________________________________________________
City/State/Zip: ___________________________________________
Phone Number: ___________________________________________
_____________________________
Applicant’s Signature
Note: Applicant must submit four (4) complete E & S plans with application.
For Office Use Only:
Application Date: _______________
Application Fee: ________________
Received by: __________________
Receipt No.: __________________
OCONEE RIVER SOIL & WATER CONSERVATION DISTRICT
90 Lanthier Street, Suite C
Winder, Georgia 30680
Telephone (770) 307-3030
TO:
Applications for Land Disturbing Activity Permits
FROM:
Oconee River Soil and Water Conservation District
DATE:
_________________________
SUBJECT:
Erosion and Sediment Control Plan Review
A conservation education contribution of $40.00 per Erosion and Sediment Control Plan is requested by the
Oconee River Soil and Water Conservation District. This is in addition to any charges by the local issuing
authorities. Upon receipt of first contribution, the district will provide the individual/business with an affiliate
membership.
Complete the following and attach a check in the amount of $40.00 payable to Oconee River Soil and Water
Conservation District.
____________________________________
Project Name
______________________________
County
____________________________________
Applicant Name
____________________________________
Address
____________________________________
Phone Number
To help us in processing your application mail check and this form within five (5) days to:
Oconee River Soil & Water Conservation District
ATTN: Susan Peppers
P.O. Box 1663
Winder, Georgia 30680
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QUAD CITIES PLANNING AND DEVELOPMENT
Representing the Cities of Arcade, Jefferson and Talmo
DEVELOPMENT REVIEW FEES
 *The fees below do NOT represent Building Permit Fees
 **All fees are to be paid at the time of submittal
 ***Re-review fess shall be based upon consultant’s fees to be paid at time of permit/approval issuance.
Project Name:__________________________________________________________________
Date Submitted:____________________________
FEE
Erosion & Sedimentation Control Review
Total disturbed acres for the project _________
Cost = $100.00 per acre or fraction thereof (minimum of $100.00)
Concept Sketch Plan Review/ Submittal
Cost = $500.00 per project
Preliminary Plat/Site Plan Review
Residential and Commercial
Number of Lots _____________
Cost = $500.00 or $20.00 per lot, whichever is greater
***Fire Suppression Review
Cost of Major = $250.00
Cost of Minor = $50.00
***Water Plan Review
Residential and Commercial
Number of Lots _______________ (residential only)
Number of Acres ______________ (commercial only)
Cost for Residential = $500.00 or $20.00 per lot, whichever is greater
Cost for Commercial = $ 500.00 or $20.00 per acre, whichever is greater
***Sewer Plan Review
Residential and Commercial
Number of Lots _______________ (residential only)
Number of Acres ______________ (commercial only)
Cost for Residential = $500.00 or $20.00 per lot, whichever is greater
Cost for Commercial = $ 500.00 or $20.00 per acre, whichever is greater
***Wastewater Lift Station Review
Cost of Duplex Pump Station = $1,000.00
Cost of Triplex Pump Station = $1,500.00
***Oil and Grease Separator OR Grease Trap Plan Review
Cost = $700.00
***Pre-treatment Plan Review
Cost = $1,500.00
***Stormwater Review
Residential and Commercial
Number of Lots _______________ (residential only)
Number of Acres ______________ (commercial only)
Cost for Residential = $500.00 or $20.00 per lot, whichever is greater
Cost for Commercial = $ 500.00 or $20.00 per acre, whichever is greater
Final Plat Review
Residential and Commercial
Number of Lots _________________
Cost = $250.00 or $10.00 per lot, whichever is greater
TOTAL REVIEW FEES
$
$
$
$
$
$
$
$
$
$
$
$
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