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Date Received: Planning Commission Date: Revised 09/13/2018 TEMPORARY USE AUTHORIZATION APPLICATION COLUMBIA COUNTY, GEORGIA Applicant Name: Date of Application: PROPERTY INFORMATION: Tax Map # Parcel # Acres: Address: Current Zoning: Current Use of Property: MOBILE HOME / TRAVEL TRAILER INFORMATION: Number Requested: Approximate Connected to Water/Sewer/Electric: Yes / No Please detail the proposed use of the mobile home(s) / travel trailer(s): PROPERTY OWNERSHIP AND APPLICANT INFORMATION: OWNER: APPLICANT: ADDRESS: ADDRESS: CITY: STATE: CITY: STATE: ZIP: PHONE PHONE#: Email (or) Fax: Email (or) Fax: I hereby depose and say under the penalty of perjury that all of the statements contained in or submitted with this application are true. This also acknowledges an understanding that a permit application must be submitted to the Building Standards Division and all inspections will be required in accordance with applicable Code(s). Owner’s Signature Applicant’s Signature Printed Name Printed Name Submission Checklist Completed application form* Location map showing the approximate area for the temporary mobile home / travel trailer* Optional items: Site photos Pictures of the proposed mobile home / travel trailer Additional information supporting the request *Required with submission