NOTICE: Any false answer to any question could result in the denial of a license, or in the event a license is issued, in the revocation
or suspension of the license.
TYPE OF LICENSE: RENEWAL ** NEW
** Applications for renewal must be filed by November 20
th
of each year or late fees will be assessed.
** Renewal Applications received on or after January 1
st
shall be treated as if it is an initial application.
The City MUST receive a copy of Proof of owner's current ownership
The City MUST receive a copy Proof of insurance indicating that the premises is used as a short-term rental
The name(s) and address(es) of all adjoining landowners of record for the purpose of providing them notice of the application Notification
Copy
Name of Business: Business Location:
Administrative: Fee Subtotal
Application Fee $50.00
Type of License: Fee
Full Year $225.00
Half year $112.50
Other:
Late Fee
$50.00
Total:
OWNER(S) INFORMATION: If such owner is not a natural person, the application shall identify all partners, officers, and/or directors
of any such entity, including personal contact information for each such natural person.
Name:
Address:
City: State: Zip:
Mailing Address:
City: State: Zip:
Contact Name/Title Phone #: Fax #:
Email Address:
The owner's agreement to use his or her best efforts to assure that use of the premises by short-term rental occupants will
not disrupt the neighborhood, and will not interfere with the rights of neighboring property owners to the quiet enjoyment of
their property
Name: Signature: Date:
_______
City of Dawsonville
415 Highway 53 East Suite 100
Dawsonville, Georgia 30534
Phone: (706)265-3256
Email: permit.tech@dawsonville-ga.gov
Website: www.dawsonville-ga.gov
SHORT TERM RENTAL
LICENSE APPLICATION
RENTAL AGENT (24 HR Contact Person)
Name:
Address:
City: State: Zip:
Title Phone #:
Email Address:
SHORT TERM DEWELLING
Address:
City: State: Zip:
The number and location of parking spaces allotted to the premises: ___________
Maximum Occupancy: ______________ Zoning:________________TMP:____________
OATH:
I, (print name), being the certify that all information contained herein is true and
correct. The application has been verified and acknowledged under oath to be true and correct by all owners, partners and interest holders. I
have received a copy of ARTICLE XI. - HOTELS AND SHORT-TERM RENTALS has reviewed it and understands its
requirements.
I understand that submittal of this application and fee does not entitle the applicant to engage in the business applied for until
such application is approved, and license is issued. I also understand that it is my responsibility to renew my license annually.
Signature of Applicant: Date:
Sworn to and subscribed before me
this ______day of _______________202_.
Notary Public, State of Georgia
(SEAL)
FOR OFFICIAL USE ONLY: RENEWAL
Notification to owners sent.
Application Compete DATE: ________
Payment Received DATE: ________My Commission Expires:
O.C.G.A. § 50-36-1(e)(2) Affidavit Verifying Status for City Public Benefit
**This form is required for ALL LICENSES/PERMITS by State Law**
By executing this affidavit under oath, as an applicant for an ALCOHOLIC BEVERAGE LICENSE, as referenced in O.C.G.A. § 50-36-1, from
the City of Dawsonville, Georgia, the undersigned applicant verifies one of the following with respect to my application for a public benefit:
1) _______ I am a United States citizen
(Must include copy of either current State Driver’s License, Passport, or Military ID)
2) _______ I am a legal permanent resident of the United States**
(Must include a copy of your current State Driver’s License and either a copy of your Permanent Resident Card or Employment Authorization
Card)
3) ________ I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with
an alien number issued by the Department of Homeland Security or other federal immigration agency.**
(Must include a copy of your current State Driver’s License and either a copy of your Permanent Resident Card or Employment Authorization
Card)
**My alien number issued by the Department of Homeland Security or other federal immigration agency is: __________________________.
The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable
document, as required by O.C.G.A. § 50-36-1(e)(1), with this affidavit.
The secure and verifiable document provided with this affidavit can best be classified as:
_________________________________________________________________________
In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or
fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as
allowed by such criminal statute.
Executed in _________________ (city), __________ (state).
__________________________________ ___________
Signature of Applicant Date
__________________________________
Printed Name of Applicant
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE ____ DAY OF _____________, 202_.
________________________________________ My Commission Expires: _____________
NOTARY PUBLIC/SEAL
