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Application for Land Disturbance Permit

Steps

  1. 1. Step One
  2. 2. Step Two
  • Step One

    1. Application for Land Disturbance Permit Banner
    2. Permit Application Information
      1. Electronic Signature Agreement
        By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
    3. Description of Property:
    4. Example:

      091 AA 0001.00

    5. Is this application for renewal of an existing Land Disturbance Permit?
    6. Description of Land Disturbance; nature, extent and purpose:
    7. Will excavated material be removed from site?
    8. Will fill material be brought onto site?
    9. If yes, is the other site covered by a Land Disturbance Permit?
    10. Permit will be issued by Building & Codes department (2nd Floor, City Hall). Applicant must show proof of Tennessee Contractor’s License and current Certificate of Insurance, in addition to payment of the Land Disturbance Permit Fee.

      Note: Permit fees - $50 per acre (or a fraction thereof) + $150 base fee.