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PICKENS COUNTY PLANNING & DEVELOPMENT 1266 East Church Street, Suite 136, Jasper, GA 30143 Phone [PHONE REDACTED] Email: [EMAIL REDACTED] Fax [PHONE REDACTED] Application for Subdivision of Parcel Subdivision Name (If Applicable): Purpose of Application: PLAT TYPE: SUBMITTAL TYPE: A) Retracement/ Boundary Line Resubmittal Plat B) Lot Consolidation Preliminary Plat (Only applicable to E) C) Lot Split Construction Plan (Only applicable to E) D) Minor Subdivision Final Plat E) Major Subdivision CURRENT ZONING: (Circle One) AG SA ER RR SR UR SPC SRPC NC HB I Acreage of Subject Property: Parcel Number(s): Current Number of Lots: Proposed Number of Lots: PROPERTY OWNER: Name(s): Address: City, State, Zip: Telephone: Email Address: SURVEYOR/ CONTACT: Name(s): Address: City, State, Zip: Telephone: Email Address: CONTINUED ON NEXT PAGE (1 OF 4) WATER: Jasper City Pickens County Well Other CHOOSE ONE: Septic Sewer Pickens County Planning & Development Office Use Only: Updated 6/30/2022 Permit Number: ---PAGE BREAK--- PREVIOUS SUBMISSION INFORMATION: Has this tract been previously submitted to Pickens P&D for approval? Y or N If yes, please provide the following information: Subdivision Name: Date of Submission: Permit Number: ACKNOWLEDGMENT All subdivisions consisting of three or more lots, which contain any lot with less than ten acres, are subject to Environmental Health approval and fees. This is a separate process from the plat approval process with Planning and Development. By Signing below, I understand and acknowledge that it is my responsibility, as the property owner/ developer/ designated agent, to ensure that these steps are followed prior to any future development on subject property. Signed Date In accordance with Pickens County Code of Ordinances, Sec. 38-690 “No person shall conduct any land- disturbing activity within the jurisdictional boundaries of the county without first obtaining a permit from the county planning and development office to perform such activity and providing a copy of notice of intent submitted to EPD if applicable.” By Signing below, I understand and acknowledge that it is my responsibility, as the property owner/ developer/ designated agent, to ensure that these steps are followed prior to any future development on subject property. Signed Date OWNER/ AGENT CERTIFICATION: - I hereby certify that this proposed subdivision plan does not violate any covenants or deed restrictions, that all taxes applicable to this property have been paid and that there are no delinquent taxes outstanding. - I hereby certify that I am the owner of the property being proposed for subdivision. - I hereby certify that I am the Owner/ Authorized Agent of the above referenced property, and that development / review fees or receipt of payment is attached. Signed Date Pickens County Planning & Development PAGE 2 OF 4 Updated 6/30/2022 SIGN SIGN ---PAGE BREAK--- Applicant’s Initials: FEE SCHEDULE: Plats containing 1-2 Minor + ( x $5.00) Total Acreage Plats containing 3-7 lots Major Subdivision $500.00 + ( x $5.00 ) Plats containing 8+ lots Total Acreage Modifications Total Application Fee: PLAT CHECKLIST Explicitly states purpose of submission Mortgage purposes, lot combination, intra-family split, etc.) Conforms to requirements as specified in Plat Act 2018 (O.C.G.A § 15-6-67) Indicates acreage of each proposed lot, proposed number of lots, and total acreage being subdivided Indicates north arrow, graphic scale, date, and exact boundary lines Indicates Subdivision Name (if applicable) Indicates adjoining property zoning classification, owner information, and current land use Indicates all existing easements with deed book or plat book reference Indicates all zoning and streambank buffers Designates any flood hazard areas Indicates setbacks from all property lines (front, sides, and rear) Includes statement that no lot can be resubdivided without written permission from Planning & Development Indicates description of any and all utility easements Indicates ROW and names of each road shown on plat (public and private) IF NEW ROADS ARE PROPOSED: Include road name approval received from Pickens County E911 IF FLAG LOTS ARE PROPOSED: Indicates minimum road frontage of 20 feet wide with the panhandle access no more than 300 feet long. Not more than two panhandle access points shall abut each other, if so combined, the width of each panhandle may be reduced to no less than 15 feet (Code of Ordinances 38-181.7) Pickens County Planning & Development PAGE 3 OF 4 Updated 6/30/2022 ---PAGE BREAK--- Applicant’s Initials: PICKENS COUNTY REGULATIONS FOR LOTS SIZE REQUIREMENTS AG SA ER RR SR UR NC HB Minimum of 10 acres for each new lot split Intra-family land split for 1.5 acres is subject to Sec. 67-8.1 Setbacks are 25ft from front, 15ft from sides and rear Minimum of 5 acres for each new lot split Setbacks are 25ft from front, 15ft from sides and rear Minimum of 3 acres for each new lot split Setbacks are 25ft from front, 15ft from sides and rear Minimum of 1.5 acres for each new lot split Can be subdivided to 1 acre if served by public water, requires Environmental Health approval Setbacks are 25ft from front, 15ft from sides and rear Minimum of 1 acre for each new lot split Subject to Environmental Health approval if not served by public water and sewer Setbacks are 25ft from front, 15ft from sides and rear Minimum of 0.75 acre for each new lot split Subject to Environmental Health approval if not served by public water and sewer Setbacks are 25ft from front, 15ft from sides and rear Minimum of 0.25 acre for each new lot split Requires Environmental Health approval if not served by public water and sewer Setbacks are 25ft from front, 15ft from sides and rear If abutting RR, SR, or UR, setbacks are 40ft sides and rear Buffer 12ft width abutting agricultural and residential districts Minimum of 0.25 acre for each new lot split Requires Environmental Health approval if not served by public water and sewer Setbacks are 25ft from front, 15ft from sides and rear If abutting RR, SR, or UR, setbacks are 40ft sides and rear Buffer 30ft width abutting agricultural and residential districts No minimum acreage for new lot splits Requires Environmental Health approval if not served by public water and sewer Setbacks are 25ft from front, 15ft from sides and rear If abutting RR, SR, or UR, setbacks are 40ft sides and rear Buffer 30ft width abutting agricultural and residential districts Pickens County Planning & Development PAGE 4 OF 4 Updated 6/30/2022 I