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SWM Permit Transfer Page 1 of 1 Note: This permit is separate from any permits required by the Montana Department of Environmental Quality. A State Stormwater Construction Permit is required for all land disturbance activities equal to or greater than one acre or for land disturbance activities less than one acre that are part of a larger common plan of development or sale that would disturb one acre or more. New Contact Information: Project Owner Contact Person: Company: Mail Address: State: Zip: Phone: Email: Fax: Mobile: Other: Contractor Contact Person: Company: Mail Address: State: Zip: Phone: Email: Fax: Mobile: Other: Engineer Contact Person: Company: Mail Address: State: Zip: Phone: Email: Fax: Mobile: Other: Stormwater Management Permit Transfer Permit Number Public Works Department 306 1st Ave East Kalispell, Montana 59901 (406) 758‐7720 Acknowledgement Certificate: I certify that I am the Owner or Owner’s authorized agent. If acting as an authorized agent, I further certify that I am authorized to act as the Owners agent regarding the property at the above-referenced address for the purpose of filing applications for decisions, permits or review under the City of Kalispell Ordinance 1600 and have full power and authority to perform on behalf of the Owner all acts required to enable the City to process and review such applications I certify that the information on this application is true and correct and I shall comply with the laws of the State of Montana and the ordinances of the City of Kalispell. Date Signed Title Project Information Project Size: (Land Disturbance) LESS than one acre GREATER or equal to one acre Signature of New Legally Responsible Person (Submission must include original signature) Name (printed) Signature of Previous Legally Responsible Person Name (printed) Date Signed Title SIGN SIGN