HomeMy WebLinkAbout009 - Notification Form' -BOZEMAN MT
Community Development
DEVELOPMENT REVIEW APPLICATION
Remember to obtain owner signature on this form prior to uploaclng wfth the rest of your SJbmittal
PROJECT INFORMATION
Project Name:
Project Type(s):
Street Address:
Legal Description:
Description of Project
C1.1Tent Zoning:
Existing Use:
Proposed Use:
Gross Lot Area:
Nl.fflber of Buildings:
Type and Nl.lTlber of Dwellings:
Building Size (SF):
Non-Residential Building Size (SF):
Building Height (ft):
Affordable Housing (YIN):
DepamreJDeviation Request (YIN):
Zonng Verification E,cpedited (YIN):
Wetlands Activity (YIN):
5532 Fowler Lane Amexation
Amexation & ntial Zone Map Amendment ANNX
5532 Fowler lane
S23, T02 S1 ROSE, N2S2SW4SW410.00AC
Amexation request for 1 0ac parcel adjacert to the city
NIA -Requesting Annexation/ Oti of City
Residential
Residential
435600
0
0
0
0
No
No
No
Traffic Study or Waiver: NIA -Application is not a Master Site Plan, Site Plan.
Is the I. ti rta· . to 6'..: ,io,.t? Slbdivision, or Plamed Development Zone.
re a pre-app 1ca on pe ming u■S pro"""": ------;-----------------
Project Name and Project NlJTlber:
PROPERTYaNNER
Company Name: KDG Holdings, LLC
Name: Kenneth Gordon
Fu! Address: 5532 Fowler Lane, Bozeman, MT 59718
Email:
Prone:
\ .
APPLICANT
Company Name: hlrinsik Arcntect\J'e
Name: _T)ie.,......,.r"""S ... te .... inwa ............ v ________________________ _
Ful Address: 106 E Babcock Slite 1A I Bozeman, Montana 59715
Email: tstei nwaw.ilinbinsikarchitecilre.com
Phone: 4062208210 -----=.;:;.;;:;.;;:;.._;. ________________________ _
REPRESENTA11VE
Company Name: htri nsi k Arcntect\.r'e
Name: _Tyte=r...;:S:;.:;te::;.:.inwa=::.i.Y ________________________ _
Ful Address: 106 E Babcock Sute 1A, Bozeman, Montana 59715
Email: tsteinway(,@inbinsikarchitectlre.com
Phone: 4062208210 -----=.;:;.;;:;.;;:;.._;. ________________________ _
CERTFICATIONSANDSIGNATURES
Applicant signatlre is captlred 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 wi II be accepted. Toe only exception
to this is an irtormal review application that may be signed by the applicant(s) only. Toe appicari(s) and property
owner(s) submit this application for review under the terms and provisions of the Bozeman Mll'licipal Code. I is
further indicated that any work undertaken to complete a development approved by the City of B02eman shaU be
in cortonnance with the requrements of the Bozeman Mll'licipal Code and any special conditions es1abfished by
the approval authority. I acknowledge that the City has an mpact Fee Program and impact fees may be assessed
for my project. Fl.l'ther, I agree to grant City personnel and other review agency representative's access to the
sl.bject site dl.ling the coi.rse of the review process (Section 38.200.050, BMC). I f'Ne) hereby certify that the
abow irlonnation is true and correct to the best of my (oll') knowledge.
Cettlfication 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 mlllicipal code provisions.
Stalement of Intent to Construct According to the Flnal Plan -1 acknowledge that construction not in
compliance with the approved fi I plan may res i dela pee ancy or costs to correct noncompliance.
Property ONner Signatlre: -+--=::;...;;:i.....,__~fr-Z-"---h"-----_.;"""-~----------
Printed Name: .:..:K::;e:;.:;nn:.:.;e::.;t:,;.;h_;;G::.;o=r=d=on _____________________ _
CONTACT US
Alfred M. Stiff Professional Blilding
20 East Olive Street
Bozemn, MT 59715
phone 406-582-2260
fax 406-582-2263
plaming@bozeman.net
www.bozeman.net/plamng