CITY OF WALTHOURVILLE Mayor Sarah B. Hayes Elected Officials CityAdministration T Luciria L. Lovette, Mayor Pro Tem Nicolas Maxwell, Fire Chief Mitchell Boston Mrs. Ivy Norris, Finance Manager Patrick Underwood Christopher Reed, Police Chief Bridgette Kelly Mr. Dave Martin, Public Works Administrator Robert Dodd Luke R. Moses, City Attorney Mayor and Council Meeting March 11, 2025 @ 6:00 PM Walthourville Police Department AGENDA I. Call to Order Mayor Sarah B. Hayes II. Roll Call City Clerk III. Invocation Appointee IV. Pledge of Allegiance In Unison V. Adoption of Meeting Agenda Councilmembers VI. Adoption of Meeting Minutes Councilmembers February 25, 2025 Special Called Meeting Minutes February 25, 2025 Regular Meeting Minutes February 25, 2025 Executive Session Minutes March 5, 2025 Special Called Meeting Minutes VII. Presentation(s) City of Walthourville 1. Mayor Hayes 2. Mayor Pro Tem Lovette VIII. Agenda Item(s) 1. LCPC Ms. Mardee Sanchez Public Hearing for Ordinance # 2025-0225-01. Amendment to the Unified Development Ordinance to add a new use fresidentialcommercial mixed use), add provisions for RV's and amendments for site plans and subdivisions. 2. LCPC Mr. Todd Kennedy Business License Request. Home based business for a pressure washing business. 3 City ofWalthourville Chief Nicolas Maxwell Lease Request. 4. City ofWalthourville Chief Nicolas Maxwell Fire Recovery Plan (Information Only). 5. Millage Update Mayor Sarah B. Hayes IX. Department Comments City ofWalthourville Water Department Mr. Patrick Golphin Fire Department ChiefNicolas Maxwell Police Department Chief Christopher Reed X. Citizens Comments Walthourville Citizens XI. Mayor's Update Mayor Sarah B. Hayes XII. Elected Officials' Comments City ofWalthourville Mayor Pro Tem Luciria L. Lovette Councilmember Mitchell Boston Councilmember Patrick Underwood Councilmember Bridgette Kelly Councilmember Robert Dodd XIII. Executive Session Mayor Hayes & Attorney Moses XIV. Adjournment Mayor and Council When an Executive Session is warranted, it is called for the following: (Litigation, Personnel and Real Estate) 1 A * * INC.I 1974 5 G RVI LE, MISANS MKOVING WIIL F IMRONING AGENDA 1 - ITEM LCPC Ms. Mardee Sanchez ORDINANCE #2025-0225-01 AN ORDINANCE TO AMEND THE LIBERTY COUNTY UNIFIED DEVELOPMENTORDINANCETOINCLUDE REQUESTED PROVISIONS AND REVISIONS TO THE SITE PLAN AND SUBDIVISION REQUIREMENTS: SAID AMENDMENTS TO BE APPLICABLE TO THE CITY OF WALTHOURVILLE: TO PROVIDE AN EFFECTIVE DATE; AND FOR OTHER PURPOSES ALLOWED BY LAW. WITNESSETH: WHEREAS, one of the purposes of the Liberty County Unified Development Ordinance (UDO) to protect the public health, safety and general welfare ofi individuals and the community; and WHEREAS, revisions were requested to clarify existing provisions, include a new use residentialcommercial mixed use) and to amend some site plan and subdivision requirements; NOW AND THEREFORE, the City of Walthourville hereby adopts the amendments below which shall become effective on April 1, 2025. Amendments to Division II - Zoning Districts Amend Table 204.1 [Schedule of Uses = Commercial Districts] to add the following new use: USE C-1 C-2 C-3 OI IC DD Notes See Sec. Residental/Commercial : P 302-12 for Mixed Use limitations. Amendments to Division III - Development Provisions Repeal Section 302-12 [Living Units in Zones other than Residential (Not applicable in Hinesville) and replace with a new Section 302-12 Residenta/Commercial Mixed Use (R/C Mixed Use)l as shown below and amend the Article 302 Table ofContents accordingly. Section 302-12 ResidentalCommercial Mixed Use (R/C Mixed Use) A. The commercial uses allowed as part of a R/C mixed use development are limited to the following: 1. Medical, dental and related offices 2. Offices 3. Personal service shops 4. Photographic, music or art studios 5. Schools of art, music and similar activities 6. Service shops and financial institutions 7. Indoor retail 8. Restaurants < 1,200 SF and cafes page 1 of9 ORDINANCE #2025-0225-01 B. A minimum of 50% of the parcel's gross floor area shall be dedicated to residential uses and a minimum of 30% shall be dedicated to commercial uses. C. Only commercial uses are permitted on the ground floor of a building on an arterial street. D. Standalone/detached single-family dwellings with no commercial space are not allowed. Sec. 302-18 (Parking of trucks, trailers and RVs (Not applicable in Hinesville) is amended to read as follows and amend the Article 302 Table ofContents accordingly: A. Within any residential district, no commercial trucks, trailers or wagons in excess of10,000 Ibs. gross vehicle weight shall be parked for storage purposes, including overnight, on any public right-of-way or on private property. B. Trailers of less than 10,000 Ibs. gross vehicle weight, including pleasure boat trailers and cargo trailers, may be parked on private property in any district provided that such trailers are parked only within areas in which the principal building, accessory building or the parking of vehicles is permitted. C. RVs may be parked or stored on private property in any district provided they are either within a building or, if outside, they are parked or stored in the side or rear yard, ifpossible. Any RV outside of an RV park shall not be used for living, sleeping or housekeeping purposes. Amendment to Division VIII - Definitions and Abbreviations Article 803 Definitions is amended to include the following new definition: Residentalcommercial mixed use - Residential and commercial uses within one building and/or in separate buildings on one parcel. Amendments to Division IV - Site Plan Review Amend Section 402-2 [General Parking Lot Requirements) subsection G [Lightingl subparagraph 5 to read as follows: 5. A photometric lighting plan shall be required if the proposed use will be open during hours of darkness and the parking lot contains more than 20 parking spaces. Ifa photometric lighting plan is required, nationally recognized lighting recommendations for illuminance levels and uniformity ratios shall be followed, such as contained in the most current Illuminating Engineering Society of North America (IESNA) Lighting Handbook. Amend Section 402-2 |General Parking Lot Requirements) to add a new subsection K Maintenance to read as follows: K. Maintenance All parking and loading areas shall be maintained free oftrash and debris. Surface, striping, curbing, lighting and signage shall be maintained in good condition. Additionally, landscaped and grassed areas around and within parking and loading areas shall be free of weeds, high grass and unpruned shrubbery and any dead plantings are to be removed and replaced. page 2 of9 ORDINANCE #2025-0225-01 Amendments to Division V - Subdivisions Amend Section 503-4(C) [Final Plat Requirements) as to read as follows, add Figure 503.5 [Certification Block for Planning Commission) and amend the Article 503 Table of Contents accordingly for this new figure: C. Certification blocks as shown in Figure 503.3 and Figure 503.5, and the applicable certification blocks shown in Figures 503.1 and 503.2 at the end of this Article. Figure 503.5 Certification Block for Planning Commission Certificate of Approval This subdivision plat has been found to comply with the Liberty County Unified Development Ordinance. Signature of Planning Commission Officer Date Printed Name Title Amend Section 503-7 Outstanding Improvements and Performance Sureties] subsections (A) and (E) subparagraph 2 [Terms of suretyl to read as follows: A. Timeframe to complete improvements Remaining improvements shall be completed within 6 months from the date of the final plat approval by the governing authority or an extended maintenance guarantee shall be provided pursuant to Sec. 503-8 [Maintenance of Required Improvements) E.2 2. The surety will not be released until the improvements have been satisfactorily completed and, as applicable and pursuant to Sec. 503-8 [Maintenance of Required Improvements), the additional maintenance guarantee has been received. Amend Section 503-8 Maintenance of Required Improvements) subsections A and C to read as follows: A. General - A surety from the developer is required prior to acceptance ofthe improvements whereby the developer shall guarantee maintenance of the primary and secondary improvements. C. Duration of the surety - The time ofg guarantee shall be 2 years from the date of acceptance of the improvements by the governing authority (see Sec. 503-9 [Dedication and Acceptance of Improvements). If the maintenance guarantee included coverage of outstanding improvements that were not completed in a timely manner as specified in Sec. page 3 of9 ORDINANCE #2025-0225-01 503-7(A) [Outstanding Improvements and Performance Sureties; timeframe to complete improvements), prior to releasing the performance surety for such improvements, an extension ofthe maintenance guarantee for the improvements shall be provided to cover a full 2 years after installation. Amend Section 504-5 [Water] subsection B subparagraph 1 to read as follows: B. Connection to municipal supply 1. Subdivisions located in or adjacent to any municipality or located within 1,000 feet to an existing municipal water system, shall connect to that municipal water system unless the municipality certifies that it will not supply water to the proposed development. Amend Section 504-6 [Sewer] subsections B, C, D, E, and G to read as follows: B. Connection to municipal system 1. Subdivisions located in or adjacent to any municipality or located within 500 feet to an existing municipal sewer system, shall connect to that municipal sewer system unless the municipality certifies that it will not provide sewer service for the proposed development. 2. Construction of the sewer system components shall comply with the municipality's standard and specifications and/or the standards and specifications of EPD. C. Connection to private system - Subdivisions that will not be served by a municipal sewer system as described above and which are located adjacent to an existing private sewer system may connect to that system provided the owner agrees to the connection in writing (recording of this document may be required) and the existing system is capable of conveying, treating and disposing ofthe wastewater. D. Community system 1. In areas not served by municipal sewer systems or other public systems, a community sewer system shall be installed in a subdivision with 50 or more lots or with potential for 50 or more lots. 2. Waiver A waiver from the requirement for a community sewer system may be granted by the governing authority ifa all the requirements below are met. Such request for a waiver shall be in writing and submitted to the plan reviewer for processing. a. For subdivisions with 50 - 100 lots or potential for that many lots, all the usable lot areas meet the minimum standard required by the Dept. of Health On-site Sewage Management System regulations or are a minimum of % acre, whichever is larger. b. For subdivisions with over 100 lots or potential for that many lots, all the usable lot areas meet the minimum standard required by the Dept. of Health On-site Sewage Management System regulations or are a minimum of 1 acre, whichever is larger. C. The soil conditions are able to support the required number of on-site sewage disposal systems as determined by the Dept. of Health page 4 of 9 ORDINANCE #2025-0225-01 E. Individual septic systems - Individual septic systems are allowed if connection to a municipal system is not required, connection to an existing private system is not an option or a waiver has been granted such that a community sewer system is not required. Individual on-site sewage disposal systems shall comply with Department of Health On- site Sewage Management System regulations. G. Pump stations - In Hinesville and Flemington, pump stations shall comply with the City of Hinesville's Sewage Pumping Station Design Guide and Specifications. In all other jurisdictions, pump stations shall comply with the requirements herein or as otherwise required by the appropriate city or county engineer. 1. All pump stations to be dedicated to a public system shall be on a tract deeded to the municipality or have a utility easement on common land owned by the HOA. Such tract or easement shall be a minimum of 4,000 SF and have a minimum width of 50 feet. To the extent feasible, all components of the pump station shall be at least 20 feet from the tract or easement boundaries. 2. Fencing shall be required along all boundaries of the tract or easement, exclusive of any access driveway. Such fencing shall be a minimum of 6 feet high and, where the tract or easement abuts a residential lot, it shall be privacy fencing soi iti is screened from the residence. A double gate a minimum of 12 feet wide shall be provided at an appropriate location. 3. Accesses to the pump station tract or easement shall be improved with a minimum 11-foot wide driveway that is asphalt, concrete or, at a minimum, consists ofa graded aggregate base course screened 1% inches or smaller with a thickness of 6 inches after being thoroughly compacted and constructed. The driveway shall be graded such that stormwater does not pond on it. 4. Controls for pump stations shall not be mounted on wood but on stainless steel or other such durable material. Amend Section 504-7 [Streets] subsections D subparagraph 5, E, F subparagraph 1 and G subparagraph 3 to read as follows: D. Alignment 5. Grades - All streets should have a minimum grade of not less than 0.30% and shall have a crown ofnot less than 3 inches. Maximum grades shall be as indicated below: a. major thoroughfares - as established by the plan reviewer. b. collector streets - 8% unless topographic conditions make this impractical. C. minor residential streets 15% unless topographic conditions make this impractical. E. Paving and marking requirements - All streets must be prepared, paved and marked in conformance with the standards below, applicable standard specifications or the State of Georgia Rules and Regulations Chapter 120-3 "Rules of Fire Safety Commissioner" currently in effect and as may be amended in the future (see Appendix I). If there are conflicts between any of these, the provisions ofChapter 120-3 shall prevail. 1. Subgrade - The subgrade shall be 24 inches of compacted subgrade material compacted to a minimum of95% density. page 5 of9 ORDINANCE #2025-0225-01 2. Base course and wearing surface a. The base shall consist of a graded aggregate base course (GAB) screened 1% inches or smaller with a thickness as indicated below after being thoroughly compacted and constructed. All materials shall be secured from an approved source and shall conform to GDOT's minimum acceptable standards fort this area. The wearing surface shall consist of 9.5 mm superpave with a thickness as indicated below and shall be placed in accordance with the latest edition of the GDOT Standard Specifications for Roads and Bridges. i. Local street - 6" GAB and 1%" superpave. ii. Collector street = 8" GAB and 2" superpave. iii. Arterial street to be determined by geotechnical and equivalent single- axel loading analysis for roadway type. iv. GDOT road = as determined by GDOT. 3. Pavement marking At a minimum, all stop bars shall be marked. Centerlines and crosswalks shall be painted on and across all collector and arterial streets. Such pavement markings shall conform to GDOT standards. Additionally, a hydrant zone shall be marked as follows: the curb along where the street widens to 26 feet and the curb directly across from this area shall be painted red, and red striping shall be marked within the widened part of the street. Stop bars, crosswalks and hydrant zones shall be shown on the construction plans. F. Drainage 1. Gutter Spread a. In all jurisdictions except Hinesville, gutter spread shall be measured from face-of-curb. Inlets shall be placed such that, for a Type II, 24-hour, 10-year storm frequency, the gutter spread does not exceed 8 feet for an inlet with another inlet on the opposite side of the street. A gutter spread not exceeding 10 feet shall be allowed on a local street ifthere is no inlet on the opposite side oft the street. b. In Hinesville only, inlets shall be placed such that, for a Type II, 24-hour, 10- year storm frequency, the gutter spread does not extend more than halfway into the travel lane. Such streets shall have a 3-inch crown as required by the City's standard detail. G. Street names and signage 1. Proposed street names shall be approved by the applicable entity authorized to do SO. It shall be unlawful for any person in laying out any new street or road to name such street or road on any plat, by marking, or in any deed or instrument, without first getting said approval. 2. Street name signs shall be installed at all intersections within a subdivision. 3. The developer shall purchase and install all necessary traffic control signs in accordance with MUTCD including but not limited to stop, speed limit, do not enter, pedestrian crossing, etc., and shall show all proposed signage on the plans. For public page 6 of 9 ORDINANCE #2025-0225-01 safety reasons, all street name signs shall be installed as soon as possible after final plat approval. Amend Section 504-12 [Other Design Requirements) subsections A subparagraph 1 and B to read as follows and delete E (it was moved to Sec. 504-6 [Sewers]): A. Lots 1. Lot dimensions - All lots shall meet the minimum lot width, depth, and area requirements of the applicable zoning district or general development plan (for PUDs). With respect to the area, the minimum lot area is usable area. B. Easements - All easements shall be shown on the preliminary and final plats and shall conform to the requirements below. 1. Access = All easements for vehicular access to a facility, infrastructure or structure shall be a minimum of 20 feet wide unless otherwise indicated herein. Additional width or areas for turning movements may be required to accommodate the vehicles that will be utilizing the access. 2. Utility - All easements for utilities such as power and cable shall be a maximum of 5 feet wide when adjacent and parallel to a street right-of-way and a maximum of10 feet wide in other locations. 3. Water (potable and non-potable) piping - All easements for underground water piping and appurtenances shall be centered on the pipe and the width ofthe easement is based on the depth ofthe pipe below finished grade as indicated below. a. Depth < 8 ft. - 20 ft. easement b. Depth over 8 ft. 20 ft. plus an additional 2 ft. for every foot deeper than 8 ft. up to a maximum easement of30 ft. 4. Sewer piping - All easements for underground sewer piping and appurtenances shall be centered on the pipe and the width ofthe easement is based on the depth oft the pipe invert below finished grade as indicated below. a. Depth < 8 ft. - 20 ft. easement b. Depth between 8 ft. and S 12 ft. - 25 ft. easement C. Depth greater than 12 feet - 50 ft. easement 5. Stormwater piping All easements for underground stormwater piping and appurtenances shall be centered on the pipe and the width of the easement is based on the size of the pipe and/or the depth of the pipe invert below finished grade as indicated below. a. Pipe with a diameter <24" and at a depth S 8 ft. - 20 ft. easement b. Pipe with a diameter > 24" or any sized pipe with a depth > 8 ft. - 25 ft. easement 6. Aboveground infrastructure - The minimum easement for aboveground or at-grade infrastructure shall be as required below. Ifan easement is needed for something that is not listed, it shall be a minimum of 20 feet around the infrastructure unless it can be demonstrated that a smaller easement would still meet the purpose ofthe easement (i.e. repair, maintenance, access, etc.) page 7 of9 ORDINANCE #2025-0225-01 a. Flumes and stone- or concrete-lined swales, ditches, etc.. Easement shall extend a min. 5 feet on either side ofthe outer edge ofthe flume or from the top of slope oft the swale, ditch, etc. Ifthe easement doubles as an access easement (i.e., for aj pond), an additional 10 feet of width on one side of the flume, swale, etc., shall be added to the easement. b. Vegetated swales, ditches, bioswales, etc. Easement shall extend a min. 2 feet on either side of the top of the slopes. If the slope of the swale, etc., is steeper than 4:1, an additional 10 feet of width on one side of the swale, etc., shall be added to the easement. C. Drainage ponds - Min. 10 feet all around the pond as measured from top of slope. Fencing is not allowed within an easement ifi it impedes general or functional maintenance of the pond. 7. Street trees - Street trees shall be planted within a 10-foot wide easement along the front property line. ** end ofamendments ** page 8 of9 a * - INCI 1974 w 6 - RVI LLE GP AINANS MOVING WILLET IMRCNING AGENDA ITEM 2 LCPC Mr. Todd Kenndy Liberty Consolidated Planning Commission - Report Governing Authority: The City of Walthourville Consol a LCPCÇ * Es Mayor & Council Date: March 11, 2025 Type of Permit: Business License = Home Based Business Owner of Business: James Nelson Business Managed By: James Nelson Property Zoned: R-8 Single-Family Residential - 8) Comments: This proposed business is a Home-Based Business that does exterior cleaning for pressure washing service for commercial and residential properties. The name of the business is called Hose 'Er Down Pressure Washing. The location is 31 Setter Lane. The Parcel Number is 052B079. LCPCZoning Recommendation: APPROVAL * Contingent upon any other applicable requirements. LCPC Staff: 51 3/7/25 Todd Kennedy Date City of Walthourville Business License Division Application for corporation or Limited Liability Company LLC Occupation Tax Certificate M33 MAT *The application must be filled out completely to obtain a City of Walthourville Occupation Tax Certificate. Payment must be filed with the application to obtain a City of Walthourville Occupation tax Certificate. This application will not be processed if it is not accompanied by the appropriate tax fee. You willr not be billed. Please print with ink or type. In order for the appropriate tax or fee to be determined the application accompanied by: all appropriate documents must be submitted in person. Pursuant to The Georgia Immigration Reform Act that was passed by the State Legislature and signed by the Governor all persons applying for renewing a City of Walthourville Tax Certificate must provide a secure and verifiable document as required by O.C.G.A 50-36-1(e) (1): and sign and notarize the affidavit required by O.C.G.A. 50-36-1 (e) (2) and the affidavit required by O.C.G.A 36-60-6 (d). This Business is: V New Application )Ownership Change / Date ownership changed & Certificate # Jlamf filling a name/or address change for Certificate# Name business as Hase 'Er Opwn Prssufe Vashing Business Phome,97)237-1134 Name of Corporation/LLC. Hose Er Down Pass ufe VAShing LLC Business Address 31 Sether LA., Allon hust GA 3130) Mailing Address_ 1266 County Ra 3365 Grohville TX 75558 Home Address 51 Setter Ln. H * City Allonhuct State_ GA Zip_ 3/39) Email Address_ hroPressure WAsling Qgmail.Com Full Detailed Description of Business Éxterior CIening + PresSule WAShiAg Scrvicc fr lonaertial d Resisential fropifties. Gaçdke CICAnig House Soft WAskiegi Rosf Softvashing Feace Reshration, Deck Cletning belor 1 Geanjag Number of employees (including ownership) in City of Walthourville E-verify# (Required if 11 or more employees) N/A State Sales Tax ID#. Federal ID # Owner Name_ Janc Nelsal SS#. DOB 08k6/1443 DOES THIS BUSINESS REQUIRE A STATE LICENSE? (YES). x (NO) (Please attach a copy ofy your state license or certification) * All electrical, mechanical, plumbing, well drilling contractors, salon, mobile home dealers, mobile home Installers, and any other contractor that isr required to have: aState of Georgia License willl be required to attach ac copy of thel license to this application before insurance. ***Allo commerciallyused building may bes subject to an inspection for fire ands safety code compliance prior toa any certificate of occupancy or business license being issued. FOR OFFICE USE ONLY ZONINGI DEPT (JA APPROVED () DISAPPROVEDI BY DATE_ FIRE DEPT ()APPROVED () DISAPPROVEDI BY DATE CITYCOUNCIL () APPROVED () DISAPPROVEDI BY. DATE BUSINESS LICENSE DEPT DATE RECEIVED BUSINESS LICENSE ISSUANCE DATE Mailing Address: P.O Box K, Walthourville, GA 31333 Phone: (912) 368-7501 Office Location: 222 Busbee Road, Walthourville, GA 31333 Web: site address: wwadhohalhounili-com City of Walthourville Business License Division APPLICATION FOR CHANGE IN LICENSE AIRISM FOR THE YEAR DATE. ACCOUNT NUMBER $25.00 CHARGE FOR RELOCATION $25.00 CHARGE FOR NAME CHANGE OF BUSINESS INDICATE THE CHANGE YOU ARE APPLYING FOR: ( NAME I ADDRESS I NAME AND ADDRESS CURRENT INFORMATION OF BUSINESS: Current business name_ Address: Owner: Manager: Nature of business: Phone number: COMPLETE ONLY THE SPACE THAT WOULD APPLY TO YOUR CHANGE: New name of business: New address of business: New manager: New phone number: The undersigned affirms that the above. statements are true and correct to the best of his/her knowledge and belief. This day of AUTHORIZED SIGNATURE OF APPLICANT PERSONNALLY before the undersigned appeared who on Oath has sworn that the above information given therein is true and correct. Sworn and subscribed before me this day of STATE OF COUNTY OF CITY OF NOTARY PUBLIC Mailing Address: P.O Box K, Walthourville, GA 31333 Phone: (912)368-7501 Office Location: 222 Busbee Road, Walthourville, GA 31333 Web site address: wwdhohaltiounlecen City of Walthourville Business License Division ARISSENTY IVC Are you, the applicant, the corporation, LLC or any shareholder currently delinquent in payment of any taxes or fees to any: state or local government? No Ifyes, please indicate the type of tax or fee, and the amount due with the reason the tax is delinquent. Ifthis property is zoned residential, no clients, employees, sales, deliveries, storage of inventory, or equipment (initals) are allowed on the premises. Only one commercial vehicle not to exceed 12,500 Ibs Gross weight used as transportation by the occupant may be parked at the residence. Jw Iswear or affirm that have obtained or will obtain within thirty days of the date of this application a City of (initals) Walthourville Certificate of Occupancy as required by the city ordinances. Jw Iwill comply with the Zoning Restrictions stated above. (initals) Jane) Nelsoy affirm that the facts stated by me are true, I understand any misrepresentation or fraudulent statement is grounds for automatic dismissal oft this application and/revocation of the license. I understand that all signs displayed on my premise must be permitted by the City of Walthourville, further understand that my business must operate in compliance with all applicable state, federal and local laws, ordinances and regulations, and that the granting oft this occupation tax certificate or payment ofthis occupation tax does not waive the right of any federal, state or local entity to regulate and enforce laws, ordinances and regulations. understand that all decisions of the Business License Division may be appealed to the City of Walthourville. This 5 day of Marck 2025 name Legibly print James Nel5oy Signature of applicant This application must be approved by the Liberty County Planning Commission Tax Map & Parcel# Zoning Classification, Approved by: Date Approved: Date the request will be presented to Mayor and Council: ***APPLICANT MUST COMPLETE THE AFFIDAVITS AND PROVIDE A SECURE AND VERIFIABLE DOCUMENT*** Mailing Address: P.O Box K, Walthourville, GA 31333 Phone: (912) 368-7501 Office Location: 222 Busbee Road, Walthourville, GA 31333 Web site address: wwdhohathounlecon CITY OF WALTHOURVILLE BUSINESS LICENSE DIVISION = LAWFUL PRESENCE AFFIDAVIT O.C.G. A. $ 50-36-1(e)(2) AFFIDAVIT By executing this affidavit under oath, as an applicant for a loan, grant, tax credit and/or other public benefit, as referenced in O.C.G.A. $ 50-36-1, administered by the Georgia Department of Community Affairs, the undersigned applicant verifies one ofthe following with respect to my application for a public benefit: 1) x Ia am a United States Citizen. 2)_ Ia am a legal permanent resident of the United States. 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. 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. S 50-36-1()(I), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: Davers License Secia) Sccurity Cofe 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 ofO.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute. Executed this the day of 20 in (city), (state). *Signature of Applicant Printed Name of Applicant SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF 20 NOTARY PUBLIC My Commission Expires: *This Affidavit must be signed by the same person who executes the Application Certification Form. Letter Mailing Address: P.O Box K, Walthourville, GA 31333 Phone: (912) 368-7501 Office Location: 222 Busbee Road, Walthourville, GA 31333 Web site address: wowdvohathounlecon CITY OF WALTHOURVILLE BUSINESS LICENSE DIVISION = PRIVATE EMPLOYER AFFIDAVIT By executing this affidavit under oath, the undersigned private employer verifies one oft the following with respect to its application for a business license, occupational tax certificate, or other document required to operate a business as referenced in O.C.G.A. $ 36-60-6(d): Section 1. Please check only one: (A), On January Is ofthe below-signed year, the individual, firm, or corporation employed more than ten (10) employees'. *** Ifyou select Section 1(A), please fill out Section 2 and then execute below. (B). On. January 15t ofthe below-signed year, the individual, firm, or corporation employed ten (10) or fewer employees. **: * If you select Section I(B), please skip Section 2 and execute below. Section 2. The employer has registered with and utilizes the federal work authorization program in accordance with the applicable provisions and deadlines established in O.C.G.A. S 36-60-6. The undersigned private employer also attests that its federal work authorization user identification number and date of authorization are as follows: Name of Private Employer Federal Work. Authorization User Identification Number Date of Authorization II hereby declare under penalty of perjury that the foregoing is true and correct. Executed on 20 in (city), (state). Signature of Authorized Officer or Agent Printed Name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF 20 NOTARY PUBLIC My Commission Expires: 1To determine the number of employees for purposes of this affidavit, a business must count its total number of employees company- wide, regardless oft the city, state, or country in which they are based, working at least 35 hours a week. Mailing Address: P.O Box K, Walthourville, GA 31333 Phone: (912) 368-7501 Office Location: 222 Busbee Road, Walthourville, GA 31333 Web site address: wwdhohwathounlecon 052B075 & : A 405 76 052B076 410 39 052B077 - 113.01 R 89 aa - - - 0 - @ s HHI 6sas HOS m l - 052B084 a 052B082 GPDBISO 052B085 - C65 OSDBZSO - 052B091 a a o8 * INCI9T 6 a G RVI LLE, AIMANS MOVING WIILE IMPRONING AGENDA ITEM3 City of Walthourville Chief - Nicolas Maxwell INCIVH * 5 RVILLE, G AIAVS MOVING WILE IMIROVING: AGENDA ITEM 4 City of Walthourville Chief Nicolas - Maxwell * * INC. 1974 6 URVIT ILLE, G AIMAVS MOVING WILET IMPRONING AGENDA ITEM5 City of Walthourville Mayor Sarah B. - Hayes