HomeMy WebLinkAbout002designreviewapp_page2 REPRESENTATIVE
Company Name: DAVID ALLEN SMITH
Name: DAVID SMITH
Full Address: 4624 MCCAFFERTYST,,_BOZEMAN,Alabama 59718
Email: skifast802 mail.com
Phone: (406)579-2588
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 oe 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 find pla��wsult in—lays of pccupancy or costs to correct noncompliance.
Property Owner Signature: ,�y/)
Printed Name: DAVID SMITH
CONTACT US
Alfred M.Stiff Professional Building phone 406-582-2260
20 East Olive Street fax 406-582-2263
Bozemn,MT59715 planning@bozeman.net
www.bozeman.net/planning