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2. Request for Survey Review

   Please complete the form, and attach your survey for review. Payment for survey approvals must be received before the Planning Department will review your survey. 

   If you have any questions while completing this form, please contact the Planning Department at (706) 864-6894.

4. Cost for Services

   Survey Review: $35.00 per review

   If you would like an additional copy, a CD of the survey or your survey emailed to you there will be an additional $5.00 charge.

   Payments can be made online or in person. In person payments can be made at the Lumpkin County Planning Department located at 342 Courthouse Hill, Suite A, Dahlonega, GA. Check and money orders should be made out to Lumpkin County Planning.

8. Name on Plat:
10. Design Professional:
12. Phone Number
13. Email Address
15. How would you like to receive your approved survey?
    -- Select One --In Person Pick UpEmail (There is an additional $5.00 charge for email)
16. Email Address:

    Address where you would like to receive the approved survey

18. Would you like any additional copies?
    -- Select One --YesNo
19. If so, how many?
    -- Select One --12345

    There is a $5.00 additional charge per copy

21. Would you like a CD of the approved survey?
    -- Select One --YesNo
22. If so, how many?
    -- Select One --12345

    There is a $5.00 additional charge per CD

24. Survey to be Reviewed

    Please attach the survey you would like to have reviewed

26. Upon completion of this form you may choose to submit or submit and print. If you choose submit and print, a browser will open with your form. If you would like to pay online using a credit card simply close the tab after printing your form and the payment portal will appear. If you choose to pay via cash, check, money order, or in person credit card you may close your browser after printing and disregard the payment portal.

    
    

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field