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2014 ZONING PERMIT FROM CITY OF BOULDER CITY OF BOULDER R RECEIVED CITY OF BOULDER MAR 2 5 7OU REQUEST FOR ACTION Type of Action Requested: Application for a Zoning Permit Single-family residential $50 All other $75 The following information must be completed for consideration by the City of Boulder. The applicant must submit an accurate and complete written application r.,r to tho 7nnina Cnmmk6nn thrm ah the ON Administrator/Mayor. All applications for use permits must be accompanied by plans drawn to approximate scale, showing the approximate dimension and shape of the lot to be built upon; the approximate sizes and locations on the lot of buildings already existing, if any; the location and dimensions of the proposed buildings or alteration; and information which clearly states how the conditions for the use will be met. Each request will require an application fee as set by the Boulder City Council. Until all applicable fees and charges have been paid in full, no action may be taken on any application or appeal. Before conducting a use, or constructing, erecting, expanding, altering or modifying a building or structure, a person must submit a completed zoning application form to the City of Boulder, with all of the required information, including plans drawn to scale, showing the actual dimensions and shape of the lot, the exact sizes and location of existing and proposed buildings and other structures. The application shall include such other information as may be required by the City Administrator, including uses of buildings and land; the number of families, dwelling units, or rental units proposed; conditions existing on the lot; and such other matters as may be necessary to determine conformance with the Zoning Ordinance. Applicant Mailing Address: RAI4 Y! `/) Phone Number: (Home) (Office) ;M57 7 0 7'y Le at Descri tjon of Property Involved (Section, Township & Range): 44 h62 1A Address of Property: 344 North Main Street (406) 225-3381 phone P.O.Box 68 (446) 225-9498 FAX Boulder, Montana 59632 CITY OF BOULDER R Page 2 General Description including descriptions of proposed buildings and alterations; existing or proposed uses of land and buildings; the number of families, dwelling units or rental units the building is designed to accommodate, conditions existing on the lot; utility access and additional requirements, address requirement for replacement of roads/alley/driveways to original state; and such other matters as may be necessary to determine conformance with, and provide for the enforcement of this ordinance: i� e Current use of the roperty/structure: Reason for the e nest: ��, c�y S L��t � e vl _f e7(4'16 564) Site Plan: 1. Property Boundaries and dimension 2. Easements, covenants, or other restriction on property 3. Size and Location of existing and/or proposed structures, and distances from structure(s) to property boundaries 4. Location of all utilities and vehicular access, including roads/alleys and driveways to property 5. Other drawings, sketches or visual information you wish to have the City of Boulder considered in this request. Other property owners or residents affected by this request (List): RA 304 North Main Street (406) 225-3381 phone P.O. Box 68 (406) 225-9498 FAX Boulder,Montana 59632 CITY OF BOULDER i R Page 3 Other evidence you wish to have conside-ed with this request (Attach): Requests for action must be submitted to: City of Boulder, PO Box 68, Boulder, MT 59632. Requests shall be specified on this form identifying action requested and --1. fhn,-nnr Am, oAAifinn nl ovhihitc flip nnnlioant wkhp¢ to hAVe considered will also be submitted with this form. City of Boulder will conduct on site inspections as warranted by the application. An affidavit of notice may be required prior to action on the request by the City of Boulder. Applicant Name: � { R Ce otr.a,ZSignature .lz Applicant Name: /1 / Signature Property Owner: to � VoV (�t?c Wyj Signature ✓�"° If different than Applicant I certify that under penal y of perjury that I am the (1) legal owner , (2) owner's legal agent or (3) the lessee ; and that the forgoing is true and correct. Applicant's Signature: Date: A Zoning Permit shall be in effect for one year from the date of approval. Type of Action Requested: Application for a Zoning Review RECOMMENDATION: Based upon the review of the Request for Action, the Mayor/City Administrator grants the request. Dated this .2G day of 2014 Mayor/Cjjj Admix nistrator 304 North Main Street (406) 225-3381 phone P.O. Pox 69 (406) 225-9498 FAX Boulder, Montana 59632