City of Dickson Public Works Department
Grading Permit
Applicant Information:
Applicant Name
*
First Name
Last Name
Applicant Phone Number
*
Please enter a valid phone number.
Applicant Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant Email
example@example.com
Project Information:
Project Name
*
Project Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contractor / Person Performing Grading / Excavating
*
Address of Contractor / Person Performing Grading / Excavating
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contractor / Person Performing Work Email
example@example.com
Total Acreage In Tract
*
Acreage To Be Disturbed
*
Does Your Submittal Include Complete Civil Design Drawings?
*
Yes
No
Are All Hydraulic and Water Quality Calculations Included?
*
Yes
No
Have You Completed a Design Review Checklist?
*
Yes
No
Signature
*
Date
*
-
Month
-
Day
Year
Date
File Upload (If maximum file upload is met, please email additional files to jstarkey@cityofdickson.com)
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