Full Text
1 I P a g e REQUEST FOR EXEMPTION REVIEW Note to Applicant: The purpose of this review is to enable Butte-Silver Bow officials to determine whether or not the proposed use of an exemption would evade the Montana Subdivision and Platting Act and the local subdivision regulations. Submit a completed application to the B-SB Planning Department. Electronic submittals may be submitted to: [EMAIL REDACTED] and [EMAIL REDACTED] Part One - Applicant Information: Landowner(s): Name: Address: Telephone Certification: I herby certify that the purpose of this exemption request is NOT to evade the Montana Subdivision and Platting Act and the B-SB Subdivision Regulations. Signature(s) Required: Date: Part Two – Legal Description: Part Three – Basis for Exemption Request: What Exemption is being claimed, and what is the basis for your exemption claim? ---PAGE BREAK--- 2 I P a g e Has a previous exemption been utilized? COS# No Does any lot/tract have an existing approved wastewater treatment system and well? Yes No Part Four – Supporting Information: Please provide all pertinent information, including an accurate certificate of survey or amended subdivision plat, as applicable and where required. FOR OFFICIAL USE ONLY Date Application Received: Date of Review: Determination: Approved. Approved with conditions outlined below. Denied. Submittal is incomplete. Return to applicant for revision. Conditions/Comments: Reviewed by: