Jefferson County, NY · Jefferson County
Planning Board Referral Notice
Municipal boards use this form to refer qualifying land-use projects to the Jefferson County Planning Board for review.
At a glance
- Issued by
- City of Jefferson County · Jefferson County, Jefferson County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- jeffersoncountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This notice is used by a municipality to refer a project to the Jefferson County Planning Board when the action and property location meet the listed referral criteria. It asks for municipal and applicant contacts, project and zoning details, the reason for referral, and a certification of submission materials. The form also lists required supporting materials, which vary by project type.
Who needs it
A municipal board referring a qualifying project should complete the notice and have an appropriate municipal official certify the submission.
How to submit it
Complete and return all three pages with the required submission materials to Jefferson County Planning and Community Development, 239m Referral, 175 Arsenal Street, Watertown, NY 13601.
About notarization
This document is signed and dated without a notary; the appropriate municipal official signs the referral certification, and no notarized attachment or related step is listed.
How to submit this form
- 1
Download the Form
Download the Planning Board Referral Notice PDF.
- 2
Complete All Three Pages
Fill in the municipal, referral, project, and zoning information, and complete the checklist certification.
- 3
Gather Required Materials
Include the applicable SEQR document, agricultural data statement, full statement, and other materials required by the local zoning law.
- 4
Send the Referral
Return all three pages and the required materials to Jefferson County Planning and Community Development at the address listed on the form.
Frequently asked questions
- Do I need a notary for the Planning Board Referral Notice?
- No. The appropriate municipal official signs the referral certification; the form does not call for notarization or list a notarized attachment.
- How do I submit the Planning Board Referral Notice?
- Return all three completed pages and required materials to Jefferson County Planning and Community Development, 239m Referral, 175 Arsenal Street, Watertown, NY 13601.
- Who completes the Planning Board Referral Notice?
- The municipality referring the project provides its information, project details, and required materials. An appropriate municipal official signs the certification.
- What materials should accompany the referral?
- The form lists a completed SEQR assessment form or environmental impact statement, an agricultural data statement when applicable, and the full statement and materials required by the local zoning law.