Montrose County Planning & Development
949 N. Second Streef Montrose, CO, 81401
Phone 97 0-249-6688 Fax 97 0-249-6680
www.montrosecounty.net
EXEMPTION FOR BOUNDARY LINE
ADJUSTMENT APPLICATION
1.
Owners:
Name
Address
CiQlStatelZip
Phone Number
2.
Applicant:
Name
Address
CitylStatelZip
Phone Number
3.
Assessor's Parcel Number
4.
Proposed Exemption Name
5.
Existing site address(es) for this property
6.
Property is zoned
7.
Legal Description of property (for metes and bounds, please attach copy)
8.
Total Acreage ofthe property
9.
Number of Proposed Tracts involved in adjustment
10.
Number of residential dwellings located on property
11.
Potable water source
Rev 10/2015
.
lynd a/mas t e r s /sub
m it t a I - ex em p
tio n
b I a.
do c
12.
Wastewater treatment source: Septic.
13.
Irrigation ditch company
Sewer
By signing this apptication, you are certifying that the above information is true and correct to the best of
your knowledge and belief.
Applicant's Signature
Owner's Signature
Date-
Owner's Signature
Date
Rev 10/2015
2
lynda/masters/submittal-exemption bla.doc
Submit these materials for packet review (not to be submitted in a binder or spiral):
tr
tr
Completed original Exemption for Boundary Line Adjustment application form.
A copy of the land owner's property record
card(s) (obtain
from the County Assessor's
ffice or online at http://eagleweb.montrosecounty.net cqll 249-3753 if you have
questions about the website)
tr
tr
A signed Permission to Enter form
tr
A
A
D" of
the
of attorney shall be provided with applications for which
the
Site Characteristics Analysis, when required under Section 10.3(C) ("Appendix
subdivision regs)
signed, original power
Applicant is not the owner of the property.
tr
tr
A current Policy of Title Insurance. Commitments for Title Insurance shall not be accepted.
One (1) folded paper copy of the Exemption for Boundary Line Adjustment Plat.
*
Additional folded copies are required after packet review. (Additional prints may be
required as needed)
tr
One (1) reduced
(l l"xl7")
copy of the Exemption for Boundary Line Adjustment Plat.
After packet review:
D
Pay application fees. (Fees are nonrefundable)
Additional plats, reports or other materials may be required during the review process.
Rev 10/2015
3
lynda/masters/submittal-exemption bla.doc
Permission to Enter Form
County Staff and/or representatives have permission to enter onto the property to be
known
as
septic inspections, driveway inspection, etc.
for the purpose of site visits,