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1 DAWSON COUNTY SHORT-TERM RENTAL/BED & BREAKFAST APPLICATION NOTICE: Any and all false information provided to the Dawson County Community Development Office verbally or written will subject the person that provides this false information to prosecution to the full extent of the law and will subject the application to denial or revocation. INCOMPLETE SHORT-TERM RENTAL/BED & BREAKFAST APPLICATIONS WILL NOT BE PROCESSED. This application must be completed when requesting a new permit, or when renewing an existing permit. A separate application must be submitted for each dwelling. Dawson County Bank Form available for credit card processing; check or money order should be made payable to Dawson County. Property Address: City: Zip Code: Owner Name: Phone: Owner Home Address: City: State: Zip Code: Owner Email Address: If such owner is not a natural person, the application shall identify all partners, officers, and/or directors of any such entity, including personal contact information for each such natural person (attach separately if necessary) Zoning classification: Tax Map: Parcel: Owner or Agent which shall constitute the responsible person and 24-hour contact: Name: Phone: Address: City: State: Zip Code: Email Address: Number of Bedrooms: Number of parking spaces provided: Maximum Overnight Occupancy: Maximum Daytime Occupancy (STR): Short-term Rental Bed Breakfast Maximum Capacity: Short-Term Rental: Overnight (between the hours of 10 p.m. and 8 two persons per bedroom plus two guests. Daytime (between the hours of 8 a.m. and 10 the maximum overnight occupancy times two Bed and Breakfast: Overnight: the number of bedrooms less one, with an overall maximum of six guest rooms, two adults per room. Ex. If a five-bedroom house is being used as a Bed and Breakfast, the occupancy would be calculated by not counting one bedroom (caretaker’s room) and then multiplying the number of remaining bedrooms, by two Only six bedrooms can be rented, regardless of the total number of bedrooms in the house, on property less than 5 acres. ---PAGE BREAK--- 2 THE FOLLOWING ITEMS SHALL BE ATTACHED TO THIS PERMIT APPLICATION: (Please check off as items completed) Proof of owner's current ownership of the dwelling unit and/or structure to be used as a A paid tax receipt for the most current year taxes paid for the property of which the dwelling, dwelling unit, building or structure is to be used as a Dwelling septic tank permit or other appropriate documentation from the Dawson County Environmental Health Office or a document from the Etowah Water and Sewer Authority which denotes the number of bedrooms permitted for said dwelling, dwelling unit, building or structure to be used as a Environmental Health may be reached at [PHONE REDACTED]. A labeled floor plan of the dwelling, dwelling unit, building or structure to be used; May be available at Qpublic website: A written certification from the Owner verifying compliance with the requirements of Section 30-510 of the Dawson County Short Term Rental/Bed and Breakfast Ordinance. **Sec. 30-510. - Life safety and sanitation.** All designated bedrooms, including egress from all bedrooms, shall comply with all applicable safety codes as were in effect on the date the short-term rental or bed and breakfast establishment was issued a certificate of occupancy. Every bedroom, adjoining hallway, and common area shall be equipped with an operational smoke detector that meets current IRC standards and shall be maintained in good working order at all times. The placement and mounting of each smoke detector shall comply with all applicable requirements of the current IRC. Each habitable floor shall be equipped with an operational carbon monoxide detector that meets applicable state law requirements and shall be maintained in good working order at all times. Each floor of a short-term rental or bed and breakfast establishment shall be equipped with a fire extinguisher that is fully charged, not past expiration date, and that meets all National Fire Protection Association (NFPA) standards, including those as set forth in NFPA 10: Standard for Portable Fire Extinguishers. Private swimming pools shall comply with the current International Swimming Pool and Spa Code. The owner shall maintain a house number that is visible from the street at all times. Sworn acknowledgement from the owner and or rental agent that he or she agrees to perform the duties specified in this article (page 3 of application). Proof of insurance for the Short-term Rental and/or Bed and Breakfast Establishment. Proof of professional trash service for the Short-term Rental and/or Bed and Breakfast Establishment, with documentation indicating designated trash collection days. Signed Code Compliance for Short-term Rental/Bed and Breakfast certification form (page 3 of application). A copy of the owners or owner’s agents’ government issued photo identification card for purposes of age verification. i.e. driver’s license or other legal identification card. The owner's sworn acknowledgement that he or she has received a copy of this article, has reviewed it, and understands its requirements (page 3 of application). The owner's agreement to use his or her best efforts to assure that use of the premises by Short-term Rental or Bed and Breakfast occupants will not disrupt the neighborhood, and will not interfere with the rights of neighboring property owners to the quiet enjoyment of their property (page 4 of application). Non-refundable initial annual fee of $300.00 Any other information that this article requires the owner to provide to Dawson County as part of the application process. The director or his designee shall have the authority to obtain any additional information from the applicant as necessary to achieve the objectives of this article. Signature of Owner/Agent: ---PAGE BREAK--- 3 DAWSON COUNTY PROPERTY OWNER ACKNOWLEDGEMENT I, (Property Owner) that I am the owner of Georgia. (Property Address) I Acknowledge that I have read the Dawson County ordinance, understand its requirements, and will comply with the regulations contained within this ordinance; I Agree to use my best efforts to assure that use of the premises by occupants will not disrupt the neighborhood and will not interfere with the rights of neighboring property owners to the quiet enjoyment of their properties; I Certify that I have confirmed and answered all the questions contained herein and know the same to be true and correct. Further, I understand that any Planning and Development department approval issued, based upon false information or misrepresentation provided by the applicant, will be null and void and subject to penalty as provided by law and ordinances; It is the responsibility of every owner or operator to make certain that the type or nature of activity being conducted at any location in Dawson County is permitted by and conforms to the Zoning Ordinance and Building Regulations of Dawson County before signing a lease/contract and before operating the business; I understand that no Dawson County permit, or otherwise, is transferable to family members or if property is sold. I understand that all construction work will require a permit prior to commencing construction, which includes alterations, modifications, renovations, remodeling, signage, etc. Working without a permit will result in a minimum penalty of $500; and I Authorize the Dawson County Marshals Office to verify information provided in the application. Signature of Property Owner Print Name: Subscribed and Sworn to me in the City of on this the day of NOTARY PUBLIC: My Commission Expires: ---PAGE BREAK--- 4 DAWSON COUNTY RESPONSIBLE PARTY (AGENT) WRITTEN CERTIFICATION Address of Property: Name of Property Owner: Agent Name: Agent Address: Agent 24-hour phone: Agent Email: (Agent) representing (Property Owner) am charged with the following duties and responsibilities for maintaining good relations between guests residing in the above-named property and the Dawson County. As the agent, I will: Be reasonably available to handle any problems arising from use of the unit; Appear on the premises of any unit within two hours following notification from the City of issues related to the use or occupancy of the premises. This includes, but is not limited to, notification that occupants of the unit have created unreasonable noise or disturbances, engaged in disorderly conduct or committed violations of the Dawson County Code of Ordinances or other applicable law pertaining to noise, disorderly conduct, overcrowding, and consumption of alcohol or use of illegal drugs. Failure of the agent to timely appear to two or more complaints regarding violations may be grounds for penalties as set forth in this Chapter. This is not intended to impose a duty to act as a peace officer or otherwise require the agent to place himself or herself in a perilous situation; *Bed and Breakfast must have an onsite resident. Receive and accept service of any notice of violation related to the use or occupancy of the premises; and Monitor the unit for compliance with this Ordinance. I verify that I am a natural person and am over the age of 21 years old. I also acknowledge that I have read and understand the Dawson County Short-Term Rental Bed and Breakfast Ordinance, understand its requirements, and will comply with its regulations. I hereby certify that I have answered all the questions contained herein and know the same to be true and correct. Further, I understand that any Planning and Development department approval issued, based upon false information or misrepresentation provided by the property owner, will be null and void and subject to penalty as provided by law and ordinances. Signature of Rental Agent Print Name: Subscribed and Sworn to me in the City of on this the day of NOTARY PUBLIC: My Commission Expires: *If the rental agent changes temporarily or permanently, the property owner must notify the Dawson County Community Development Office in writing of the new agent's identity. Only one agent may be in place at any given time.