Liberty County Building and Licensing Department

Building Application

Owner/Applicant:

Property Address:

Mailing Address:

Telephone #:

Contact Name & Telephone #:

Contractor: *General:

*Electrician:

Class of Work:

Flood Zone:

How Deep is the pool?

Overall Width

Overall Length:

Please attach the following:Zoning Approval Letter

Copy of Plot Plan

Copy of Sales Contract

Complete Set of Plans

Copy of Pool Contractors Business License

Copy of Electricians Business License

FOR OFFICE USE ONLY

Director Approval:

___________________________

Date: _________________

Inspector Approval:

__________________________

Date: _________________

Map & Parcel # Lot #: Zoning:

Swimming Pool

I understand that the swimming pool must be fenced in by a four foot (4') or higher fence.

Signature Date

In order to obtain a permit for swimming pool you must have the following information:

Estimated Cost:

Electric Company:

Contact Email Address:

Affidavit Form

The issuance of this permit authorizes improvements of the real property designated herein which improvementsmay subject such property to mechanic's and materialmen's liens pursuant to Part 3 of Article 8 of Chapter 14 ofTitle 44 of the Official Code of Georgia Annotated. In order to protect such property and to avoid encumbrancesthereon, the owner or any person with an interest in such property should consider contacting an attorney orpurchasing a consumer's guide to the lein laws which may be available at building supply home centers.

You are responsible for approvals from any subdivision Property Owner's Association for covenant requirementsproir to actual construction.

For Houses Being Built In Flood Zone AreasThe regulation to build at or above the required flood elevation has been explained to me. I understand that areasbelow the required elevation may only be used for the parking of vehicles, building access (staircase orfloodproofed elevators) and limited storage for equipment necessary for lawn or building maintenance. Iunderstand that to enclose beneath the required elevation, there are strict requirements pertaining to hydrostaticvents or breakaway walls depending on the flood zone in whuich the building is located and that there can be nopartitioning of rooms. I further understand that should I violate any of these regulations I may be required toremove the enclosure, that my insurance carrier may be notified and that further remedy may be sought throughthe courts.

An elevation certificate is required upon completion of the slab/floor before continuing up with the walls.

I have been explained and understand the regulations pursuant to the State of Georgia Water Quality Control Act,Title 12 Chapter 5- that NO CONSTRUCTION may occur within 25 feet of the marsh, 50 feet on waters designated as"trout streams", as delineated by the Georgia Department of Natural Resources. These setbacks are consideredpermanent buffers and shall remain in its natural and undisturbed state.

Date Signature

Driveway Culverts are handled by the Liberty County Road Department. Please call 912-884-3310 to have one installed.

Property lines must be marked before any inspections can be made. Please pull strings.

All Commercial Establishments must have a bulk refuse waste container.

All Contractors and Private Home Builders must have an on-site bulk refuse container for collection and disposal ofconstruction/demolition waste.

Burning or Burying of any construction/Demolition material is a violation of State Law.

Please call for inspections. Allow at least 24 hours advance notice.

I am aware that this project may be in violation of Federal Wetland Regulations and that I am responsible forcontacting the Savannah District Office of the U.S. Army Corp of Engineers (USACE) at 912-652-5279 for adelineation of wetlands on my property before begining this project.

I herby certify that I have read and examined this permit application and know the same to be true and correct. All provisions of laws andordinances governing this type of work will be complied with whether specified herein or not. The granting of this permit does notpresume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance ofconstruction. This permit becomes null and void if work or construction authorized is not commenced within (6) six months or ifconstruction is suspended or abandoned for a period of (1) one year at anytime after work is commenced.

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Affidavit Form

Printed Name:

LCPC Use Only

Zoning Permit

Tax Map & Parcel # :You can obtain this number by calling the Tax Assessor's Office at 912-876-3568.

Property Owner:

Contact Name & Number:

Contact Mailing Address:

Property Street Address (if existing):

Subdivision: Lot: Jurisdiction:

What are your permit plans?

Type of water and sewer: If other explain:

What structures are on this property?

I confirm that these statements are true:

List Zoning Designation

Unincorporated Area of Liberty County City of Walthourville

City of Flemington City of Midway City of Riceboro

Town of Allenhurst City of Grumbranch City of Hinesville

Setbacks: Front Rear: Side: Side Street:

Mobile Home Requirement: Size: Skirting Type:

Comments:

Approved; meets Zoning Standards Disapproved, does not meet Zoning StandardsLCPC staff: Date:

Floodplain Manager Use Only

Flood Zone: Elevation:FEMA Map Date: FIRM Map & Panel:

Jeff Ricketson, AICP

Executive DirectorLiberty Consolidated Planning Commission

100 Main Street, Suite 7520Hinesville, Georgia 31313Phone: 912-408-2030Fax:1-888-320-8007

Jurisdiction

H City of HinesvilleLC Unincorporated

Liberty CountyM MidwayW WalthourvilleA AllenhurstG GumbranchR RiceboroF Flemington

Contact Email Address: