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Community Development
DEVELOPMENT REVIEW APPLICATION
Please remember to obtain owner signature on this form prior to uploading with the rest of your submittal. (Digital signature
acceptable.)
PROJECT INFORMATION
Project Name:Campeau Home
Project Type(s):Neighborhood Certificate of Appropriateness NCOA
Street Address:415 South Grand Bozeman, Montana 59715
Legal Description:
FAIRVIEW ADD, S07, T02 S, R06 E, BLOCK 3, Lot 6 - 7, PLAT C-3
Description of Project:
A new Residential construction,
Current Zoning:R-4 Residential High Density District
Existing Use:Residential
Proposed Use:Residential
Gross Lot Area:8400
Number of Buildings:[NumberofNewBuildings]
Type and Number of Dwellings:1
Building Size (SF):2308
Non-Residential Building Size (SF):0
Building Height (ft):
Affordable Housing (Y/N):No
Departure/Deviation Request (Y/N):No
PROPERTY OWNER
Company Name:CAMPEAU ANTONI A
Name:Tony Campeau
Full Address:415 South Grand, Bozeman, MT 59715
Email:tcampeau@montana.edu
Phone:(406) 491-0466
APPLICANT
Company Name:Formation Architecture
Name:Craig Bergstedt
Full Address:po box 762 , manhattan, Montana 59741
Email:CRAIG@FORMATIONMT.COM
Phone:(406) 284-4476
REPRESENTATIVE
Company Name:Formation Architecture
Name:Craig Bergstedt
Full Address:po box 762 , manhattan, Montana 59741
Email:CRAIG@FORMATIONMT.COM
Phone:(406) 284-4476
CERTIFICATIONS AND SIGNATURES
Applicant signature is captured electronically at time of application submittal. This application (PDF) must also be
signed by the property owner(s) for all application types before the submittal will be accepted. The only exception
to this is an informal review application that may be signed by the applicant(s) only. The applicant(s) and property
owner(s) submit this application for review under the terms and provisions of the Bozeman Municipal Code. It is
further indicated that any work undertaken to complete a development approved by the City of Bozeman shall be
in conformance with the requirements of the Bozeman Municipal Code and any special conditions established by
the approval authority. I acknowledge that the City has an Impact Fee Program and impact fees may be assessed
for my project. Further, I agree to grant City personnel and other review agency representative's access to the
subject site during the course of the review process (Section 38.200.050, BMC). I (We) hereby certify that the
above information is true and correct to the best of my (our) knowledge.
Certification of Completion and Compliance - I understand that conditions of approval may be applied to the
application and that I will comply with any conditions of approval or make necessary corrections to the application
materials in order to comply with municipal code provisions.
Statement of Intent to Construct According to the Final Plan - I acknowledge that construction not in
compliance with the approved final plan may result in delays of pccupancy or costs to correct noncompliance.
Property Owner Signature:
Printed Name:Tony Campeau
CONTACT US
Alfred M. Stiff Professional Building phone 406-582-2260
20 East Olive Street fax 406-582-2263
Bozemn, MT 59715 planning@bozeman.net
www.bozeman.net/planning