SuretyRelease/ReductionRequestForm
Planning&BuildingServicesDepartment
PlanningDivision

200S.WillowSt.
P.O.Box1727
Jackson,WY83001
ph:(307)7333959
www.tetoncountywy.gov

SuretyRelease/ReductionRequestForm
1 Updated4/15/2019
ForOfficeUseOnly
FeesPaid
Check#CreditCard Cash
Application#
Approve________Deny__________Date__________Initials___________
PROJECT
Application#
PhysicalAddress:
Lot,Subdivision: PIDN:
OWNER
Name: Phone:
MailingAddress: ZIP:
Email:
APPLICANT/AGENT
Name: Phone:
MailingAddress: ZIP:
Email:
SURETYINFORMATION
LetterofCredit/Check/Bond#:
CurrentExpirationDate: CurrentSuretyAmount:
Reduction_______ORFullRelease_______ Amount:
Underpenaltyofperjury,IherebycertifythatIhavereadthisapplicationandassociatedchecklistsandstatethat,tothebestof
myknowledge,allinformationsubmittedinthisrequestistrueandcorrect.Iagreetocomplywithallcountyandstatelawsrelating
tothesubjectmatterofthisapplication,andherebyauthorizerepresentativesofTetonCountytoenterupontheabovementioned
propertyduringnormalbusinesshours,aftermakingareasonableefforttocontacttheowner/applicantpriortoentering.
SignatureofOwnerorApplicant/AuthorizedAgent Date
NamePrinted Title/Role
click to sign
signature
click to edit
SuretyRelease/ReductionRequestForm 2 Updated4/15/2019
CHECKLIST OF SUBMITTAL REQUIREMENTS
______Letter of Authorization A letter of consent from the landowner is required if the applicant is not the
landowner, or if an agent is applying on behalf of the landowner.
______Fee Fee of $50.00 is required with a submittal of a reduction request and/or a release request, in accordance
with currently adopted fee schedule found on the website
For Partial Releases
______Estimate Provide an estimate of work completed and a revised estimate of the cost of work remaining
under the original obligation. The estimate should be prepared by a qualified professional, such as
an engineer, landscape architect, or environmental professional, depending on the nature of the
project.
For Full Releases
______Estimate Provide an estimate of work completed. The estimate should be prepared by a qualified
professional, such as an engineer, landscape architect, or environmental professional, depending
on the nature of the project.
______Evidence of Inspection Provide evidence of the required final inspection conducted by the Planning
Director, County Engineer, or their designees as appropriate.
Please note that a Warranty Period applies, and a Warranty Period Financial Assurance is required. You may not
request full release of the assurance until the Warranty Period is complete, unless you provide a separate Warranty
Period Financial Assurance, in a form acceptable to the County as outlined in Section 8.2.11 of the LDRs.