HomeMy WebLinkAbout017-280-001TO: Building Department
FROM: Encroachment Permit Section
RE: Driveway Clearance
owner location
Driveway permit 2 ? has
i
si.Aature
'a)
11--44--al -
AP #
been issued for the above property.
41�
date
�; w ,.9't'. ,+4v�,t�1-�.+�i1.4"�tity3 1"K A+,. ,�ra,'17�„'i�T .'' �,; Z 1 �-'_ ri r .•?
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form'per Building)
A. P. Number 4/41 — O Building Department No.
School District C `;c O City Q County � Jurisdiction
Property Ownera,ber9L //<Dr�ID�✓
Project Location/Addres
G
Subdivision 115A W 5 e.A/ Lot Number
Residential Development:
Sq. Footage ,;2o� b L%
# of Living MHI Addition (Group R)
Units
1
Commercial/Industrial: Sq. Footage
} New Addition (Including Exterior
Roofed Areas)
Building Department Representative Date
District Id No.
-ems-- f
ip1icant N
a/S
y'oo 9a _1
School District certifies that
(Phone Number)
(Street Address/)
C_X / . I 6A 2S
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.
by the payment of $ /JQ,_). n t5 representingsquare feet.
alo�
/ Sch`-ol District res tative D6.te
PAID BY CHECK NO.
BANK NO -
PAID BY CASH
REMARKS:
white -applicant, yellow -building department, pink -school district
SCHOOL . FEE (5/88)
IT,
STATE OF CALI FORN [A Iss.
COUNTY OF F__11 -F te
un— July 28, 1988 before me, the undersigned, a Notary Public in and for
said State, personally appeared Mollie L. Morto'n and
personally known to me (or proved to me on the
E
r_
basis of satisfactory evidence) to be the persons who executed the within instrument as
C1
E
r
W KY X X
P s1896 WLX—Secretary,
on behalf of
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R b t I t liqc
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y—
o e r o r o n ,
................
t*��o C
the corporation therein named, and acknowledged to me t at
h
OFFICIA L SEAL
a
LUCY A. PERSHALL
suchcorporation executed the within instrument pursuant to its
#0
NOTARY PUBLIC - CAL
by-laws or a resolution of its board of directors.
WORNIA
BUTTE COUNTY
tj.'
�co j�
WITNESS m y hand and official seal.
:
my Comm. E -,p. Jan. 10, 1§§j
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0
�re
�����=,'qEND
Sign�
(This area for official notarial seal)
OF DOCUMENT
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