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1 Dawson County Community Development RESIDENTIAL BUILDING PERMIT APPLICATION check all applicable Etowah Water City of Dawsonville Well Septic (on-site) Amicalola Electric SEPTIC SERVICE: ELECTRIC SERVICE: HEAT SOURCE: ADDRESS: PARCEL SIZE: AREA OF LAND TO BE DISTURBED: DESCRIPTION OF THE PROJECT: INSTALLATION OF: 1 Any project involving more than one acre of disturbed area or is within 200 feet of the bank of any state water requires submittal of an Erosion Control Plan to the Natural Resources Conservation Service, [PHONE REDACTED], [EMAIL REDACTED]. The approved erosion control plan is a required component of the application for a residential land disturbance permit (two step process). 2 State waters excludes drainage areas which have water only during and immediately after rain events and intermittent streams which do not have water in them year-round. provided, however the responsible party must prevent sediment from moving beyond the boundaries of the property. PARCEL TAX I.D. Propane Sawnee EMC Plumbing HVAC Number of Stories: WATER SERVICE: Number of Bathrooms: Number of Bedrooms: CHECKLIST Complete Application (Page 1,2, and 3) Recorded Plat (Dawson County Clerk of Court) Site Plan/House Location Plan. Delineate the size and exact location of proposed and existing structures on the site, distances from all lot lines and2 streams; stream buffers, and proposed driveway location. Delineate the minimum setbacks of the applicable zoning district; as well as proposed setbacks; retaining walls, landscape walls. Floor plan of bedrooms, bathrooms, location of decks) ESTIMATED COST OF CONSTRUCTION DEMOLITION PERMIT ONLY *(NO CONSTRUCTION) Community Well Sewer Georgia Power Gas Signature required on page 3 *EXISTING STRUCTURES: Electrical components Business License GA State Contractors License Electrical/ Plumbing /HVAC Subcontractor Affidavits Septic Tank Permit /Letter (Envior. Health Dept.) Restroom Facilities Form (Envior. Health Dept.) Public Water Availability written confirmation Etowah Water & Sewer; Community Water; Well Service Proof of taxes paid (tax receipt) Land Disturbance Permit (READ 1 BELOW) Driveway Permit )if applicable) Permits will not be issued in a floodplain. ---PAGE BREAK--- 2 Porches: 2nd Floor: Patios: Storage: 1st Floor: Decks: Garage: Basement: PROJECT DETAILS IN SQUARE FEET Wood Wood Cedar Shake Metal Covered porches: Floor: Concrete Walls: Metal Roof: Asphalt Shingles CONTRACTOR: CONTRACTOR'S Email address: 24-hour Soil Erosion Emergency Contact STRUCTURE SETBACKS (MUST MATCH PLAN) FRONT: REAR SIDE SIDE Corner lots have two front yard setbacks; See Land Use table 3.1 ; check stipulations of zoning Contractor'sLicense# 24-hour emergency number: ELECTRICAL CONTRACTOR: HVAC CONTRACTOR: PLUMBING CONTRACTOR: PROPERTY OWNERS NAME: PROPERTY OWNERS ADDRESS: CONSTRUCTION MATERIALS: STAFF CHECK: DEVELOPMENT IN THE FLOODPLAIN RUSSELL CREEK PROTECTION AREA ZONING STIPULATIONS OWNER BUILDER (SELF BUILD) COMPLETE SECTION ABOVE WITH "N/A" FOR CONTRACTOR'S LICENSE # RETAINING WALL(S) ---PAGE BREAK--- 3 1. Signature of Applicant/Owner/Authorized Representative Date 2.11.2025 Release Form Initial item 1 ; check items 2-5 Sign and date form. All projects must be designed and constructed in accordance with the following adopted codes: 2018 International Building Code with Georgia Amendments 2018 International Residential Code with Georgia Amendments 2018 International Swimming Pool and Spa Code with Georgia Amendments 2018 International Fire Code with Georgia Amendments 2018 International Plumbing Code with Georgia Amendments 2018 International Mechanical Code with Georgia Amendments 2018 International Fuel Gas Code with Georgia Amendments 2015 International Energy Conservation Code with Georgia Amendments 2023 National Electrical Code with Georgia Amendments 2010 Department of Justice ADA Requirements Dawson County Land Use Ordinance (Municode.com) Georgia Soil and Erosion Best Management Practices Acknowledgment (initial) of construction codes as listed above. 2. If the property is adjacent to an Agricultural District, an ongoing use which may produce odors, noise, dust, and other effects which may not be compatible with the applicant’s project/ development. Nevertheless, understanding the effects of the adjacent Agricultural use, the applicant agrees by executing this, to waive any objection to those effects and understands that the permits are issued and processed in reliance on this agreement not to bring action asserting that the adjacent uses in the Agricultural district constitute a nuisance against local governments and adjoining landowners whose property is located in an Agricultural district. 3. Temporary electrical connection shall not exceed the period of time in which the building permit is valid or completed. Not to exceed the permit(s) that the state licensed electrician who has requested this release accepts all liability and responsibility for the use of electricity at this locations. It is understood that no occupancy will be allowed during this temporary connection period and any violation will result in a citation and disconnection of service without any notice. By requesting this inspection, the licensed electrician, builder, and/or owner understand the requirements for temporary power and will relieve Dawson County and it’s inspectors from any liability or loss for ordering connection or disconnection of electrical service. It is also understood that a Dawson County Business License is required or signed affidavits to be able to work within Dawson County. 4. Any person acting without a licensed residential contractor to build a home on their real property, shall not be eligible to construct another residential structure 24 months from the time a Certificate of Occupancy has been issued. Further, such person may not delegate the responsibility to directly supervise and manage all or part of the work relating thereto to any other person unless that person is licensed by the State of Georgia. O.C.G.A.43-41-17 5. A complete set of approved plans and specifications SHALL BE MAINTAINED ON THE CONSTRUCTION SITE ; Inspections shall be failed if the inspector is unable to access the approved plan set and permit documentation. SIGN