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Community Development
DEVELOPMENT REVIEW APPLICATION
Remember to obtain owner signature on this form prior to uploading with the rest of your submittal
PROJECT INFORMATION
Project Name:Nollmeyer Annexation & ZMA
Project Type(s):Annexation & Initial Zone Map Amendment
ANNX
Street Address:West end of Oak Street, west of its
intersection with ForestGlen Drive.
Legal Description:
Tract 2 of COS 3181A, in the W1/2 of SW1/4
of section 4 & the E1/2 of the SE1/4 of
Section 5, T2S, R5E
Description of Project:
Annex a 34.86 acre parcel which is adjacent
to the existing city limit into the City of
Bozeman.
Current Zoning:N/A - Requesting Annexation / Out of City
Existing Use:Undeveloped
Proposed Use:Residential
Gross Lot Area:1518500
Number of Buildings:
Type and Number of Dwellings:
Building Size (SF):
Non-Residential Building Size (SF):
Building Height (ft):
Affordable Housing (Y/N):No
Affordable Housing Incentives (Y/N):No
Conducted the required Community Meeting (Y/N):
Departure/Deviation Request (Y/N):No
Zoning Verification Expedited (Y/N):No
Wetlands Activity (Y/N):Yes
Traffic Study or Waiver:N/A - Application is not a Master Site Plan,
Site Plan, Subdivision, or Planned
Development Zone.Is there a pre-application pertaining to this project?:
Project Name and Project Number:
Is the primary structure being claimed as unsafe per 38.240.020.K?
Requesting Concurrent Construction?
Ditch within 100 feet?No
Ditch impacted by offsite improvement?No
2635706.09.26PLNAPP 19023
PROPERTY OWNER
Company Name:4 Bozeman, LLC
Name:David Hargrove
Full Address:16274 West Main Street, PMB 213, Bozeman, MT 59715
Email:david@4rland.com
Phone:4069229770
APPLICANT
Company Name:Headwaters Engineering Inc.
Name:Jeremy May
Full Address:1105 Reeves Road West, Suite 6 , Bozeman, Montana 59718
Email:jmay@headwatersmt.net
Phone:4065815730
REPRESENTATIVE
Company Name:Headwaters Engineering Inc.
Name:Jeremy May
Full Address:1105 Reeves Road West, Suite 6 , Bozeman, Montana 59718
Email:jmay@headwatersmt.net
Phone:4065815730
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:David Hargrove
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