Cascade County Determination Request Form
Cascade County Planning Department
121 4
th
St N, Suite 2H-2I
Great Falls, MT 59401
Phone: 406-454-6905 | Fax: 406-454-6919
Email: planningcomments@cascadecountymt.gov
September 21, 2020
Request No.: _____________
Assoc. Permit: ____________
Request Date: ____________
This form is for requesting a determination. Please provide all relevant information about the subject property, the property
owner, and the applicant as it pertains to the request. Please indicate the specific regulations/ordinances (if any) of your
inquiry and provide a thorough description of the request in the space provided.
0BSubject
Property
Township
Range
Section
COS No.
Subdivision (if applicable)
Parcel No.
Geocode
Total parcel area
Address
Zoning District
1BProperty
Owner
Name
Address
Phone Number
Email
Applicant
(Contractor, Engineer,
etc. who is filling out
this request form)
Name
Address
Phone Number
Email
Specific Regulations/Ordinance (if any):
Zoning
Floodplain
Subdivision
Building for Lease or Rent
Ordinance/Other: ________________________________________________________________________________
Request:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Attestation Statement and Signature:
I hereby certify that the information given herein is true and correct.
Signature of Applicant: ___________________________________________________ Date: ______________________
Signature of Property Owner: ______________________________________________ Date: ______________________