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ATHENS-CLARKE COUNTY PLANNING DEPARTMENT Athens-Clarke County Planning Department I 120 West Dougherty Street I Athens, GA 30601 I [PHONE REDACTED] accgov.com/planning I Page 1 of 1 I Revised January 2022 For Staff Use: PLAN FP - - - FINAL PLAT APPLICATION FEE: Minor Subdivision (four lots and fewer) – $75 base fee plus $30 per lot Major Subdivision (over four lots) – $150 base fee plus $30 per lot [not to exceed $500] • Recombination – $50 (Check with staff to determine exact fee – cash/card/check - make check payable to ACC ∙ please print clearly) You are proposing to: (please check) Create New Lots Combine/Recombine Lots SUBMITTAL INFORMATION: (for initial submittal and each revision you will need the following) 1. Three paper copies 2. One CD or USB (with copies of plan in PDF format for 10 or less sheets DWF for more than 10 sheets) Name in Title Block: Subdivision Section (if applicable): Street Address and /or Street Name(s): Tax Map Number(s): Total Acres: Parcel Zoning(s): Current # of lots: Proposed # of Lots: The proposed parcels are served by [Check all appropriate box(s)]: □ Public Water and Sewer □ Public Water and Septic □ Well and Septic CONTACT INFORMATION Property Owner (required) Professional Representative Name: Name & Company: Address: Address: Phone: Phone: Email: Email: Applicant □ Same as Owner □ Same as Representative Other Name: Name: Address: Address: Phone: Phone: Email: Email: Project contacts to receive email correspondence and updates to application status (circle all that apply): Applicant Professional Representative Owner Other OWNER/REPRESENTATIVE’S SIGNATURE: DATE: FOR STAFF USE ONLY: Digital: □ Yes Received by/Date: 3 paper copies: □ Yes