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This section is to be completed by the individual filling out this form.
If the property owner is different than the applicant, his/her information goes here.
Fill in all information regarding the permitted property.
Must be licensed in the State of Georgia
By submitting this application, the applicant hereby certifies as follows: 1) that he/she is authorized to make this application; 2) that all information provided by the applicant, whether on an original application or on an application for a revision, is true and correct, including all information on any attachments thereto; 3) that, on an application for revision and all attachments thereto, he/she has brought to the attention of the Permitting Office all changes being made from the original application and attachments thereto by highlighting those changes on this form and the attachments; 4) that he/she will comply with all regulations of Charlton County which are applicable hereto; 5) that he/she will perform no work on the above property not specifically described in this application; 6) that he/she grants Charlton County officials the right to enter onto the property for the purpose of inspection the work permitted and posting notices.
This field is not part of the form submission.
* indicates a required field