Three future development pattern scenarios of the Upper Etowah Region were created representing a continuum from sprawl to smart growth. A GIS was used to measure the impacts on stream health and rural land covers from the build-out of each scenario. A literature review was also conducted to assess any differences in public costs expected from the build-out of these scenarios. The smart growth scenario that directs development into mixed-use, clustered neighborhoods was found to be more protective of stream health and rural land. This scenario is also expected to result in more compact service delivery systems and thus, less public costs. The legal and market hurdles to implementing this smart growth scenario are discussed.