Brookhaven, GA · DeKalb County
Land Disturbance Permit Revision Application
Property owners or their representatives use this application to provide project and applicant details when requesting a revision to a land disturbance permit.
What this form is
This application is for a revision to a land disturbance permit and asks for the original permit number, project details, property information, applicant contact information, and a description of the revision. The signer certifies that the information is true and agrees to the stated permit conditions, including that construction will begin within six months of permit issuance.
Who needs it
A property owner or the owner’s representative requesting a revision to a land disturbance permit needs to complete and sign this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application has no notary block; although its terms say the signer states the information is true “upon oath,” it only provides signature and date lines.
How to submit this form
- 1
Download The Application
Download the Land Disturbance Permit Revision Application PDF.
- 2
Complete The Form
Enter the original permit number, project and property information, applicant contact details, and description of the revision.
- 3
Sign And Date
The property owner or owner’s representative signs and dates the application.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the application request?
- It asks for the original permit number, project and property details, applicant contact information, and a description of the requested revision.
- Who signs the application?
- The form provides a signature line for the property owner or the owner’s representative, along with a date line.
- Do I need a notary for the Land Disturbance Permit Revision Application?
- No. The form has no notary block; its terms refer to a statement made “upon oath,” but provide only signature and date lines.
- How do I submit the application?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Land Disturbance Permit Revision Application doesn’t need a notary — but if you have another Brookhaven form that does, a commissioned online notary can help.