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TETONCOUNTYSCENICPRESERVETRUST

CONSERVATIONEASEMENTREVIEW(EAS)

APPLICATION

Planning&BuildingServicesDepartment

PlanningDivision





200S.WillowSt.

P.O.Box1727

Jackson,WY83001

ph:(307)733‐3959

www.tetoncountywy.gov

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

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ConservationEasementReviewApplication

1 Updated4/15/2019

ForOfficeUseOnly

Application# 

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PROJECT

Name/Description:

PhysicalAddress:

Lot,Subdivision: PIDN:

Existingeasementinformation(Documentnumberorbookandpagenumbers

fromtheClerk)





APPLICANT/OWNER

Name,Agency: Phone:

MailingAddress: ZIP:

E‐mail:



AGENT

Name,Agency: Phone:

MailingAddress: ZIP:

E‐mail:



DESIGNATEDPRIMARYCONTACT

 Applicant/Owner  Agent

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APPLICABILITY This application should be used when applying for review of a Teton County Scenic Preserve Trust (TCSPT)

ConservationEasement.ThepurposeofthereviewistoensurethatanyTCSPTconservationeasement,oranychangetoanexisting

TCSPTeasement,isincompliancewiththeOpenSpaceResourcesResolutionofTetonCounty,Wyoming.



AnEASapplicationisrequiredinthefollowingsituations(checkwhichapplies):

 Dedicationofrequiredconservationarea 

 AlandownermayrequestthattheTCSPTacceptdedicationofaneweasementtofulfillarequirementoftheLDRsorfor

anotherreason.Forprojectswithrequiredconservationareas,thefollowinginformationshallbesubmitted.Itmaybe

submittedseparatelyormay

beincludedintheDevelopmentOptionapplicationpacket.(LDRsourceofrequirementin

italics)(OpenSpaceResourcesResolutionofTetonCounty,WyomingDecember22,2015,Sections4,5,7,8,9,Easement

mendments).



ConservationEasementReviewApplication 2 Updated4/15/2019

1.EnvironmentalAnalysis(Section7.3.3.B.1.aandSection8.2.2).

Inthecaseofnewlycreatedopenspaceeasements,thisdocumentmayalsoserveastheBaseline

Inventory/DocumentationoftheConditionoftheOpenSpaceLandreferencedintheeasementwhenwildlifeisa

conservationvalue.Theapplicantshouldbeawarethatit

mayneedtobesupplementedwithon‐sitephotographsof

thecurrentconditionsoftheland.

2.ConservationAreaConfiguration(Section7.3.3).

AmapthatdemonstrateshowtheconfigurationandlocationoftherequiredopenspaceprotectstheConservation

ValuesidentifiedinSection7.3.2.A,ConservationValues,andSection7.3.3,

ConservationAreaConfiguration.(Thismay

beincludedintheEnvironmentalAnalysisreferencedabove.)

3.ProposedRecordofRestriction(Section7.3.5).

Acopyofthelegalinstrumentthatshallprovidefortheperpetualpreservationoftherequiredopenspace.Ifnot

alreadyrecorded,thedocumentshallindicateaproposedGrantee.Allexhibitsreferencedinthedocumentshallalso

beprovided.



 Requesttoamendeasementtermsonexistingopenspace 

 PropertieswithanexistingopenspaceeasementheldbytheTetonCountyScenicPreserveTrustmayrequestto

amendtheopenspaceeasementincertainsituations.PleaseseetheOpenSpaceResourcesResolutionofTeton

County,WyomingDecember22,2015,Section

10,EasementAmendments.Section10.2Aliststhestandardsfor

consideringtheapprovalofopenspaceeasementamendments.Section10.Bdescribestheprocedureforsubmittingan

amendment.

 Requesttotransferaneasement

 EasementsheldbytheTrustmayberequestedtobetransferredtoanother qualified organization.PleaseseetheOpen

Space Resources Resolution of Teton County, Wyoming December 22, 2015, Section 11, Easement Transfers for the

standardsthatmustbemetforthetransferofaneasement

.



SUBMITTAL REQUIREMENTS Please ensure all submittal requirements are included. The Planning Department will not hold or

processincompleteapplications.



____ElectronicSubmittalAcompletedigitalfileoftheapplicationwithattachments/plans

____HardCopySubmittalAcompleteprintedfileoftheapplicationwithattachments/plans

____Notarized Letter of Authorization A notarized letter of consent from the landowner is required if the signatory on this

applicationisnot

theowner.PleaseseetheLetterofAuthorizationtemplateonthewebsiteforasample.

____DeedAcopyofthemostrecentlyrecordeddeedtotheproperty



Note:Informationprovidedbytheapplicantorotherreviewagenciesduringtheplanningprocessmayidentifyotherrequirementsthat

werenotoriginally

evident.Theapplicantisresponsibleforfulfillingalllegalrequirementsofallagencies with jurisdiction overthe

proposedproject,whetherornotthoserequirementsarefullyidentifiedinthischecklistorinrepresentationsmadebyanyindividual

orrepresentative.



Underpenaltyofperjury,IherebycertifythatIhavereadthisapplicationandassociatedchecklistsandstatethat,tothebestof

myknowledge,allinformationsubmittedinthisrequestistrueandcorrect.Iagreetocomplywithallcountyandstatelawsrelating

tothesubjectmatterofthisapplication,andherebyauthorizerepresentativesofTetonCountytoenterupontheabove‐mentioned

propertyduringnormalbusinesshours,aftermakingareasonableefforttocontacttheowner/applicantpriortoente ring.



SignatureofApplicant/OwnerorAuthorizedAgent Date



NamePrinted Title/Role



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