BILLINGS COUNTY APPLICATION FOR BUILDING & ZONING CERTIFICATE
TAX EQUALIZATION & ZONING OFFICE APPLICATION:_________
DATE ISSUED:_________ EXPIRES:_________
PHONE: (701) 623.4810 ● FAX: (701) 623.4761
495 4
TH
STREET ● PO BOX 247 - MEDORA, ND 58645-0247
stswanson@nd.gov jhammerstrom@nd.gov REVISED 5/2015
INSTRUCTIONS:
1. For new buildings and additions to existing
buildings, complete entire form
2. Include all necessary drawings in the
space provided and attach any house
plans, surveys, etc. to the application
3. Return completed application and fees to
the Tax Equalization & Zoning Office
before proposed upcoming zoning meeting
which is posted at
http://www.billingscountynd.gov/BillingsC
ountyZoning.htm
LOCATION OF PROPOSED STRUCTURE:
Rural Billings County
Address: __________________________
CERTIFICATE FEES, CHECK ALL THAT APPLY:
$_______ .............. Zoning Application Fee*
$_______ .............. Conditional Use Permit*
$ 200.00.................. Temporary Use Permit
$ 200.00..................................... Variance
$ 200.00.................. Change in Zoning District
$________Total Paid Receipt: __________
*Fees vary by Zoning District. See Billings County
Fee Structure for Planning & Zoning Applications.
Make Check Payable to: Billings County
APPLICANT INFORMATION*: Name: ________________________________________________________
Mailing Address: ________________________________________________
City, State Zip: ________________________________________________
Phone Number: ____________________ Cell: ________________________
Email: _______________________________________________________
*If applicant is not the owner of record, enclose a letter from the owner stating concurrence of this action
for the proposed use of the property.
TYPE OF PERMIT:
Zoning Certificate
Zoning Change from _________________________ to ______________________________
Variance Requested .......A variance is needed if the building proposal does not meet ordinance
requirements and cannot reasonably be changed to meet standards. See
Billings County Ordinance 7.4
Conditional Use .............A conditional use is permitted in a district specifically permitting it, subject
to the approval of the County Commission and only when the commission
finds that such use meets all applicable, including but not limited to those
contained in this ordinance. See Billings County Ordinance 7.3
ESTIMATED VALUE OF CONSTRUCTION AND IMPROVEMENTS: $____________________________
LEGAL DESCRIPTION OF BUILDING SITE:
Lot: _____________ Block: ___________ Subdivision: ________________________________________
Qtr/Qtr: _________ Section: _________ Township: ______________ Range: ______________________
PARCEL NUMBER:__________- _________ - _________ - __________
