HomeMy WebLinkAbout039-460-077COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 PERMIT NO.
(Rev. 12/96) APPLICATION, AND PERMITAr
ASSESSOR PARCEL NUMBER
039-460-077
ZONING
7
BUILDING PERMIT
OWNER
Cortez Moe -
TELEPHONE
T
SO. FT. OCC. BUILDING VALUATION
.OWNERS MAILING ADDRESS
2233 Oak Wav Chico CA 95973
837 R 153,198.00
822 U 14 796.00
CONTRACTOR'S NAME
TELEPHONE
377 C 4,901.00
1•00
CONTRACTORS MAILING ADDRESS
POBox 81 Durham CA 95938
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace A
1500.00
Total Valuation $
.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 902.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 986.30
eu GApD,
l•�
'� f ha �_
Energy Plan Checking Fee
$ 23.00
master
$ 23.00
PERMIT FEE $1554.30
Lor167
SUBDIVISIONS NAMEDurham Estates $)J,`3
PARCEL MAP
PLUMBING PERMIT
Fling Feel 20.00
USE OFSTRUCTURE j,p�(C
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.0091,00
Solar or heat pump water heater
23.00
Water piping
15.0015.00
Each as water heater or vent
15.00 15,00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Master #01-09 NSF
F�b' X T aJ5�C
Gas piping system 1 - 5 outlets
15.0015.00
Building sewer
15.00 15-00
Mobile Home I S I G I W
920.00
PERMIT FEES
ELECTRICAL PERMIT
Fling Fee 1 20.00
Main Service aOOV OR LESS
200" OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect. 6 !
License Class Lie. No. (O
8
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BLDS.
s0
3.50 --
NEW CONST. MULTI.OUTLET
NONRESID.
@7.50
POWER APPARATUS
a SINGLE OUTLET CIA.
Ex. Occup. OUTLET OR FIXTURES
BAS p x.50
Ex. Occup. GuTE�°Ts" R= .) E
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$
171 0
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of C rnia, and agree that if I should become subject to the
workers' compensate ovisions of section 3700 of the labor Code, I shall
forthw' h co ply wit a provisions.
4o0' /
X ate �
can
re of A plicant - er Contractor ❑ Agent
An OSHA permit is required for excav tions over 60" deep and demolition or construction
of structures over 3 stories i height.
MECHANICAL PERMIT
riling Fee 20.00
Heating 1 25 00
Cooling
Hood 6.50
Ventilation 6.50
PERMIT FEE $
Mobile Home Installation Fee $
EnergyInspection Fee V46 , 00
c PE TOT L FEE $
HAZ. D. FEESC
EL
HD
This permit i hereby issued under
of the Bu ty Code and/or
indicate e r hich fees ve
B
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
d
Date O
6
to1
Receipt No.
WHITE-D.D.S.-B. CA Y SSESSOR PINK -INS ECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT AP.P&IEi,' ION DATA SHEET
OWNER: 7—_ ASSESSOR PARCEL NUMBERrC'/ O
Proposed Building Use: VU� Counter Technician: la�_Date: / L
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
5 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 4vr
:V3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2s �'of stamped and signed calculations.
'7- 4. Engineered truss details and layouts in duplicate. No faxes!
:Z:5. Energy compliance design and supporting documentation in duplicate. •.
❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all err plicate.
07. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. Alf these must be
stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and
returned to the plan review line-up when required items are received.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate..
❑ 9. Site plan and business license approval from the City of Biggs......
❑ 10. Letter of intent for non-residential buildings ...............................
❑ 11. Detached Accessory Building Form filled out by the owner........
❑ 12. Hazardous Material Form ......................................................
❑ 13. Fire Sprinklers....................................................................
❑ 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner
❑ 15. Other
Date Received By
Sent by
tRaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
Fees as shown on the attached Schedule of Fees Due Sheet .......................................
Statement of Intent for Non -heated and A/C Buildings......................................Sanitation and site plan approval from the Environmental Health Department inCity of Chico Plumbing permit........................................................................
0 20. California Department of Forestry plan approval ❑ paid. Sent by: ......................
0 21. Planning approval for (A) Use: oK (B)Parking: (C) Parcel Check:
❑0222j Contact Land Development about ❑ Improvements, ❑ Drainage .......................
,'�H`" NPDES Form............................................................................................. 7 z 3
❑ 24. Encroachment Permit for driveway from the Public Works Dept .................................
❑ 25. Pre -Inspection for required ................
❑ 26. Contractor's license information. (Number, Name Style, Classification) ......................
❑ 27. Worker's Compensation Carrier and Policy Number .............................................
O 28. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
4211_etter of Signature authorization....................................................................
0. Recorded copy of Agricultural Acknowledgment Statement .................................... Pjvl
❑ 31=` Manufactured home utility clearance...............................................................
❑ 32. Existing violations and/or expired permits.........................................................
❑ 33. ❑ Grant Deed, 0 M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 34. Other:
When issued Telephone/Q�� C �� and hold for pickup.
I have been informeWhe above item�d requirements for obtaining a building permit.
App cant: Z 1 1 / l / // Dale: - 77— z
1. I ex pe it apple above item Bred: Plan Check Letter
Additional items required
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the above data by O phone, ❑ mail, ❑ counter, by4 4 Date:
Plans reviewed by: Date: Plans approved by: Date:
Structural reviewed by: Date: Structural approved by: Of Date:
Note transfer by: Date:
Yellow: Building Division
rA
7P
TO:^ Building Department
1 FROM: Environmental Health
SUBJECT: -Sanitation Clearance
E.H. USE ONLY
Piot Pian Attechod
AGO? Pun Attpchad
�• ''S3nt to B.D. f' — 'v
1 �D T.ES AroT/% �E7XyP.SF%✓_/.�T�.t D3%-h(/OG- 072
C
Owner
Plan Approved for: Sewage Disposal -�
Clearance for Other
Location AP#
Water Supply: Public Private Well
NOTE:
V
9
Environmental Health Specialist
8/96
Date
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541
SCHEDULE OF'RECEIPT OF FEES
OWNERall
A.P. # D3� d �b7
PROPROSED BUILDING USE DATE a
RECEIPT # DATE REC.
� 1. BUILDING PERMIT FEES
--- Balance Due ..................... $
--- Additional Fees Due........... $
-- Revised Plan Checking Fee.... $
2. SCHOOL DISTRICT FEES +1
aid at School District Office form available after Plan Check ` I
3. SHERIFF FEES
(Paid at Building Division) 3 J�
Residential............ X $360.00 =$
Units
Commercial (sq. ftg.)..... X $0.03 = $
Sq.Ftg.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit)..... X = $
t:N■nn :rta
Commercial (Sq. Ftg.).... X = $
Sq. Fig. Amt. Q� n
4�5. RECREATION DISTRICT FEES p t/
(paid at Recreation District Office) (form available after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
7. SRA FIRE INSPECTION AND PLAN CHECK FEE
$89.00 (paid at Building Division)
8. WATER TENDER FEES BATTALION #
$200.00 (paid at Building Division)
9. NORTH CHICO SPECIFIC PLAN (paid at Building Division)
Residential Zone X = $
Zone # Units Amt.
Commercial (sq. ftg.) ......... X = $
Sq. Ftg. Amt.
10. OTHER
At time of permit application, as advised the ove es are required to be paid prior to issuance of the permit. These fees
m e changed during the the gZpros/s.APPL ANT g::7 a 3
Pursuant to G014.1.ent Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 abo a may have been imposed on your project. You
have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a
protest are specified in Government Code Section 66020(a).
Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003)
F)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUt
DING DIVISION
7 County Center Drive Oroville, California 95965 • Telephone (5 538-754b� HERMIT 0�
VNER
APPLICATION AND PERIVIIY ��MBER ZONING BUILDINGPERMIT
3 5 -
NONE SQ. FT. OCC. BUILDING VALUATION
/ �^ — �-�^�u�ss nit /I ) LA 01L /7 9 1—f % 3
EONSTRUCTION LENDER
ENDERS MAILING ADDRESS
ARCHITECT OR ENGINEER
ARCHTECT OR ENGINEER'S MAILING ADDRESS
SURDIJGADDRESS n _
PARCEL
LOT
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
TYPE OF WORK
New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
114
Describe Work:
4 - L% V3U T3�
vowt�
SRNoter , v
a
Ntarn
CC" �Avr
Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA ermit is required for excavations over 60° deep and demolition or construction
Fireplace I /q' 1
Iaz 4 .so
1,600
Total Valuatic Is.
5.00
vi L4 -,117 )r-
RlinqFee
$
20.00
Permit Fee
$q
10U
Plan Checking Fee '
$
Energy Plan Checking Fee
$
a
$
a3 U d
PERMIT FEE
$
1,56-q,.3
PLUMBING PERMIT
f' as- "
Filing Fee 20.00
Each Trap
/ ;L5'—
7.00 b D
Solar or heat pump water heater
6.50
23.00
Water piping
15.00 �—
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00 r
Building sewer
15.00 /j �—
Mobile Home IS G W
(ED20.00
/
": o0 1.)
PER IT FEE
/910-06
ELECTRICAL PERMIT
r
Filing Feel 2.0.00
eow OR LEsLESS
Main Service 2ooA DR s
23.00 a ,Q
Main Service 200A TO +000A
46.00
NEW CONST. / oWELLWG OCCUP.
OR ADDNS. \ 6 ACC. BLDS.
3.50SO '
NEW CONST.�MULTI.OU=
.-I
unwI,
@7.50
Ex. Occup. oun Er OR FIXTURES
Iaz 4 .so
Ex. Occup.MIS ESle.oeA
5.00
Temporary Service
23.00
Moble Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
S 1-7/.0_5'
MECHANICAL PERMIT
Filing Fee
20.00
Heating
f' as- "
>
Cooling
/ ;L5'—
.1 "
Hood
6.50
^p
Ventilation
wtFSmL 1 rCC I a,
KEnergy
ome Installation Fee $
nspection Fee $ ip•000NST. TYPE TOTAL FEE $ � pul NAZ- D. FEES IMP . Ft.O* CDF PARCS. PD HD
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
P
of structures over 3 stories in height By
Receipt No. PERMIT EXPIRES ON
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Date
0
!�I
SITE PLAN REVIEW APPLICATION
Date: C).- 0--z-, AP# 039 , y %d - 0 -7 -7
Permit Number (if applicable) 2.`Z-3
APPLICANT INFORMATION Parcel Size: 1 I0 Ll AC
Owners Name: G0Q - F_Z ; Y�F� N U'_1._.11
Owners Address:
Telephone No.: SZD G b -� Z
eS ;
Situs Address: � -
Proposed Use:
Residential
ju New Single Family Residential
❑ Single Family Addition
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
❑ Single Family Remodel
❑ Commercial Remodel
❑ Industrial Remodel
Other
11 Septic ❑ Well
❑ Agricultural Exempt Building
Other: A 1_3 V -P -P
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
❑ Approved It Conditionally Approved ❑ Resolve Problems Prior to Approval
® Site Plan Stamped Approved
By�e Date 16-7 8-n, fn
Page 1 of 5
I,
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In: 1
❑ Snow Load Area:
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required)
'❑ SRA - (CDF to determine specific requirements)
El 100 -Year Flood Plain: (See attached)
• Flood Zone:
• Flood Panel No.: Index Date:
❑ Sacramento River Reclamation District (Approval must be obtained'from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mu I berry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
❑ Minor Variance ❑ Variance
-------------------------------------- --------------------------
❑ Detached Building Use Form ❑ Encroachment Permit.
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning:
L�
Applicable Building Setbacks:
i
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SR.A'setbacks.
1S
Page 2 of 5
Zoning Code
Streets & Highways
; Fire Prevention
Subdivision Map
Front
'Side
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SR.A'setbacks.
1S
Page 2 of 5
Applicable Development Fees:
Standard Fees Amount Formula
• ❑
Fire
❑
School*
❑
Parks/Recreation
❑
Roads
❑
Sheriff
❑
Drainage
❑
NCSP/CSA 87
❑
Chico Urban Area — Road
❑
Thermalito Drainage Area
❑
Thermalito Urban Area
❑
Other
-------------------------------------------
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
• Parcel Created By
Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ 'Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
•------------------------------------------------------------------------------------------------------------------------------
Page 3 of 5
in Subdivision Map/Parcel:Map: -DV tZl--A�\—
Map Date of Recording:
Lot:
10-- 3D- P,> 1
❑ Use Permit/Minor Use Permit
Permit Number:
0
Book: Page. /
Date of Approval:
Parcel Map/Subdivision Map/Use Permit Conditions' t
Comply with the following Conditions of ApprovaL• ATJ TIi C,H
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
.. i
h
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkle# systems in one
and two family dwellings and mobile homes, NFPA . Standard 13D,' unless a. pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel r
❑ Wood stoves and fireplace inserts shall be EPA approvedrand designed'to eet the emission
requirements ofahe California Clean Air Act of 1988, as amended.
5
❑ Provide an erosion control plan for building and land disturbance. 'The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works. j
i
❑ In lieu of a pressurized water system or water storage tank, payment into -the appropriate
Battalion Water Tender Fund may be required.
i
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for road maintenance, and stop sign maintenance.
ON
Page 4 of 5
.�--------
— — LEACH FREE SETBACK (LFS)
•
07 S,.
1. Tires SHEET SHOWS ADDITWNAL INFORMATION, IS FOR
ADDITIONAL INFORMATION PURPOSES ONLY, DESCRIBING
CONDITIONS AT THE TIME OF FRIG AND IS NOT INTENDED TO
AFFECT RECORD TITLE INTEREST.
2. A SOLID FENCE CHAIN LINK, BRICK, BLOCK OR SIMILAR
MATERIAL, NOT WOOD, A MINIMUM OF SIX FEET IN HEIGHT SHALL
BE INSTALLED ALONG THE SOUTHERN AND WESTERN PROPERTY
LINES OF THE PROJECT. PRIOR TO ISSUANCE OP BUILDING PERMITS
FOR ANY RESIDENCE IN PHASE 3.
3 DEVELOPMENT OF ALL LOTS IN THIS SUBDIVISION WILL REQUIRE
CONNECTION TO A PUBLIC WATER SUPPLY.
4. SHOULD ANY ARCHAEOLOGICAL OR CULTURAL MATERIALS BE
ENCOUNTERED DURING PROJECT CONSTRUCTION. SITE DEVELOPMENT
SHALL CEASE AND ARCHAEOLOGICAL CONSULTATION SHALL BE
IMMEDIATELY RETAINED.
5. ALL ALMOND TREES SHALL BE REMOVED FROM T14E PROPERTY.
REMOVAL OF TREES CAN FOLLOW THE PROPOSED PHASING PLAN
SHOULD ACTIVE FARMING CONTINUE AS THE PROJECT IS
DEVELOPED. -
6. A DEVELOPMENT IMPACT FEE FOR SHERIFF'S FACILITIES SHALL
BE PAID PURSUANT TO THE PROVISIONS OF CHAPTER 3, ARTICLE II
•
OF THE BUTTE COUNTY CODE, PRIOR TO ISSUANCE OF BUILDING
PERMITS OR USE PERMIT IN THE CASE OF A MOBILE HOME PARK.
SAID FEE AMOUNT WILL BE DETERMINED AND CALCULATED AS OF
THE DATE OF APPLICATION FOR THE BUILDING PERMIT OR USE
PERMIT.
—
7. ALL OAK TREES ON THE PROPERTY SHALL BE PRESERVED
l
EXCEPT FOR THOSE REQUIRED FOR ROADS, DRIVEWAYS, OR
p
BUILDINGS. A NO DISTURBANCE SETBACK SHALL BE PROVIDED
,,A _ -
COMMENCING FROM THE OUTER EDGE OF THE OAK TREE CANOPY.
3s
1
ADDITIONAL INFORMATION SHEET
DURHAM LAND ESTATES
PHASE 3
A PULUC snag SURD vr&M
BEING A PORTION OF THE
REMAINING LANDS OF DURHAM LAND ESTATES
PHASE X BOOK ZI OF MAPS, PACE 71-74,
ALSO ,BEING A POR77ON OF THE
0
•
May 21 03 01:28p r ��04 p. 1
JUN 111 2003
BUTTE COUNTY
AGRICULTURAL BUFFER
UNUSUAL CIRCUMSTANCES FORM
Butte County requires a 300' buffer between agricultural operations and a residence. This dimension
is based on environmental assessments and studies. The Agricultural Commissioner may identify
unusual circumstances where the 300' dimension cannot be met on existing parcels. This exception is
not available for lots being divided or subdivided.
Applicant must complete the following and return with the required site plan to:
Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601
Name: I''1 >g� v�2 GEJ i' �� Phone: S Z� — I� 3 z
APN: 7-2
Reason you believe you qualify for the unusual circumstances exception:
...s Date
UNUSUAL CIRCUMSTANCES DEFINITION:
An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement
(well septic, etc.) does not allow for the standard condition of a 300 -foot buffer zone.
SITE PLAN REQUIREMENT:
Drawn to scale
Assessor's panel number
Owner's name, property address and street name
Size of parcel (dimensions and acreage)
North arrow
All improvements - existing or proposed (structures, wells, septic system, etc.)
Frontage Road serving parcel
Use of adjacent properties (all sides) showing type of fanning and other improvements (wells, septic, structures)
Driveway width and length
For office use only:
DISCRETIONARY PERMITS (alanninti) MINISTERIAL PERMITS (building
fi( Exception Recommended ❑ Exception Granted with the
❑ Exception NOT Recommended following conditions:
Reason/Conditions/Specific setbacks from adjacent agricultural operations: Lo -t' 4*�1-7
NO o Psra*r--, yip b-vr-k jEe ce cr
Agricultural Department Signature: Q e tiLu� Date: o(o A, d
b1P c -
YMC 4/10/03
_ _ 228'
'LAGEMENT FIELD —
_
400' TOTAL LINEAR FT.
---------- LEACH.--
I
------------------
----------------- I
-----------------
I
I
—MARSH DRIVE
LOT 564164 sq. ft. S I TE FLAN
BUILDING 3685 s . ft.
COVERAGE I.qI
LOT 6
GREGORY A. P E I T Z DURHAM LAND ESTATES L O T
ARCHITECT for: 1 �%
383 Rio Undo Ave. Chico, CA. 95926 (530) 8945719 STEVE E GRA '' S 1 /
11 DURHAM, CALIFORNIA
0 _
n
t6
a
0.3�- �O —O 7 7
Environmental Health
JUN9 ` 2003
Chico, CA
�� nI—.. , , c T /1
National Pollutant Discharge Elimination System (NPDES) Phase II &
SWPPP Non -Certification for Project # for Butte
County Storm Water Permit Compliance
By signing below, I, the project architect/engineer of record, indicate that I am aware that a
construction project that disturbs more than 1 acre of land requires a Construction Storm Water
Permit from the State Water Resources Control Board. I, additionally, understand that it is the
project owner's/owner's agent's responsibility to submit a Notice of Intent (N.O.I.), a Storm
Water Pollution Prevention Plan (SWPPP) and a fee of $700.00 to the State Water Resources
Control Board to obtain such a permit. I, further, certify that this project will not disturb more
than 1 acre of land. I have also reviewed the Best Management Practices Handbooks, California
Storm Water Quality Task Force, Sacramento, CA. I certify that appropriate BNTs will be
implemented to effectively minimize the negative impacts of this project's construction activities
on storm water quality. I acknowledge that it is my obligation to make the project owner and
contractor aware that the selected BMPs must be installed, monitored, and maintained to ensure
their effectiveness. If, at any time, site conditions and/or observations by a County official
warrant reevaluation and revisions of the chosen BMPs, the appropriate changes will be made
without unnecessary delay. I am aware that failure to properly implement and maintain the
BNIPs necessary to prevent the discharge of pollutants from this project during construction
could result in significant penalties and/or delays.
Signed:
Title:
Date:
13y signing below, I, the project owner/owner's agent, certify that I am aware that a construction
project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from
the State Water Resources Control Board and that it is my responsibility to submit a Notice of
Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00
made payable to the State Water Resources Control Board to obtain such a permit, if my project
disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1
acre of land. This document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified individuals properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons
directly responsible for gathering the information, I certify, to the best of my knowledge and
belief, that the information submitted is tru , curate, and complete.
Signed:
Title:
Date: 77
NPDES & SWPPP Non -Compliance Certification Draft
Butte County Stormwater Plan
4
School District
A.P. Number U
Property Owner
Property LocatiokAddress
i
BUTTE. COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
i ;
Building Department No.
Subdivision Y �,f /��/ �G��.-t/J Lot No. / l
V Yb
Commercial/Industrial
New Addition
Sq. Footage
(Including Exterior
/^ Roofed Areas)
U
Date
1moor runs reviewed oy scnooi uistnct rersonneq
t
District Identification No.
�t-t4 a -ko I P d School District certifies that
y
(Applicant) `
(Street Address) 3, / - 4L6G . 7 --7 (Phone Number)
�ti✓�_a....�--1 Cot- � ��--9 � (J .. .
(City) (State) (Zip Code)
has complied with the'requirements of Resolution No. U� �� b a meet of $ p II,
. YP Y rDi) %�. /a
api square feet. AB 2926 $
FULL MITIGATION $ Rgp esentative Date
Paid by Check # /
Remarks:
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
thisproject may be subject to additional school fees to fully mitigate its impact on the school district's schoolsmay be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/9877m
M
��/j'�"� \ T'�; �' n� .'iC1 '1. 'r 1• r wA it �1i f �.Tr'�4c"S �:.�iy'*. r ti'., s��r. N"1 r.+t'(r•.r...y`•p1C�.•rr.�'S�"�' .�2�`t•'Y�F,' 7�'-M.r.".�'�{'1..ia
-�- BUTTE COUNTY PARK FACILITY FEE PAYMENT CERTIFICATION FORM
DURHAM RECREATION:AND PARK DISTRICT
1.o77
Assessor Parcel Number (s):
Property Owner (s):
Project Location/Address: /u/ / 7
Subdivisons Name:Y,,CA_ Assessable Square Footage: e.3
Type of Residential Development (check one):
New Development ❑ Afteration'Addition Mobile Home (s)' Non -Residential to Residential
Comments:
Building Division Representative Date
Durham Recreation and Park District (DRPD) certifies that
ve 5 64"6 6o L/ - 0,3 8 0
Applicant Name Applicant Phone Number
1
Street Address
fi
City State Zip Code
has complied with the requirements of the Butte County Board of Supervisors Resolution No.
93 - 114 by paymet`for 231 square feet at $ 1.04 per square foot for a total payment
of $
,r
U1 o' c�u� 503
LORPD Representative Date
PAID BY CHECK No.: Remarks:
BANK No.: cI b-. 3`3 D q 9
PAID BY CASH:
RECEIPT No.:
DISTRIBUTION: WHITE - APPLICANT PINK - DRPD YELLOW -'BUTTE CO. BUILDING DIVISION
v.w
20030801
Agricultural Statement
Recorded
I REC FEE 1:
. UfficialyyRecords
I
Coun]4 Of
Butte County Building Division
7 County Center Drive
.' eA><1DACE J. GRilBB5
Recorder
I
1
OrovilIe, CA 95965
ROSEMARY DICKSON
I
Assistant
I Alyce '
09:00AM 31 -Jul -2003
I Rage i of 3
20030801
Agricultural Statement
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DMSION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 16-8 of the Butte County Code requires this acknowledgment to be recorded
prior to issuance of a building permit The property described herein is adjacent to
land or included within an area zoned for agricultural purposes, and residents of
this property may be subject to inconveniences or discomfort from the use of
agricultural chemicals, including, but not limited to herbicides, pesticides, and
fertilizers; and from the pursuit of agricultural operations including, but not limited
to cultivation. plowing, spraying, pruning, and harvesting which occasionally
generate dust,.smoke, noise, and odor. Butte County has established agricultural
purposes and residents within said zones and on adjacent property should be
prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described
as follows:
Date: PROPERTY OWNERS:
State of California)
County of �c - I-
On � S -0 3 before me,k7 -,mak S F r� ersonally
appeared 1a o v,%&, � C: (�,e' � S 'fpersonally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that
he/she/they executed the same ' his/her/their authorized capacity(ies), and that by
his/her/their signature(s)oCtIfe instrument, the person(s) or the entity upon behalf
of which the person(s cedi, executed the instrument.
WITNESS my h,4 kAd official seal.
gn !/ —�� ����/� Seal:.,�►,�ri
Si afar ,. DENISE M. PRIC@
C�nMM. #1341260
WTARY PUBLIC o CALIFORNIA �
CCIU(M OF BJTTE
0411 IOP Expires Jan, 24, 2006
Description
The land referred.'to herein is situated in the State of California, County of Butte,' and _is described as
follows:
LOT 17, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DURHAM LAND ESTATES PHASE
311, WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF
BUTTE, STATE OF CALIFORNIA, ON OCTOBER 30, 2001, IN BOOK 152 OF MAPS, AT PAGE(S)
79, 80 AND 81.
THIS DEED IS MADE AND ACCEPTED UPON THE COVENANTS, CONDITIONS AND
RESTRICTIONS .AS SET FORTH IN THAT CERTAIN DECLARATION OF RESTRICTIONS
RECORDED NOVEMBER 7, 2001, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 2001-
,51759, BUTTE COUNTY, CALIFORNIA; ALL OF WHICH ARE INCORPORATED HEREIN BY
REFERENCE THERETO WITH THE SAME FORCE AND EFFECT AS THOUGH FULLY SET
FORTH HEREIN AT LENGTH AND GRANTEES BY ACCEPTANCE ON THIS DEED APPROVE,
ADOPT, RATIFY AND AGREE TO THE TERMS OF SAID DECLARATION.
APNS 039460-024-000 (PORTION) AND 039-460-040-000 (PORTION)
REPLACEMENT FIELD
400' TOTAL LINEAR FT.
- - - OF LEACH. -
I
----------------- I
----=------------
APPROVED ----------------- I
i& -0 -?-)
150J Esrwv- G 7YZ—
mironmental Health
J U N 'f - 2003
Chico, CA
r;a\' LNG DIVISION -BUILDING PLAN APPROVAL
use:01I < Dace: R
Pa,4ng: Landscaping:
signakm.
228.50'
LOT 0 LOT
GREGORY A. P E I T Z DURHAM LAND ESTATES
ARCHITECT for .17 /—�
383 Rio Lando Ave. Chico, CA. 95926 (530) 894-5719 STEVE GRAVES /
11 DURHAM, CALIFORNIA
SE -:e, A14:5
= B:'>FiUCI MBS AND EQIWWENT mcwD m
n OV RHANC38 SHALL BE GEAR OF ALL EASEMEW&
A SET BACK OF*0-'! FT. FROM THE SIDE AtO
. :EjMZ FT. FROM THE REAR PROPERTY LINES AN6
FT. FROM THE LOAD CENTERLINE SHALL BE -
CLEAR OF 'STRUG`i'URES AND EQUIPMENT EXCWT
FOR A 2 E7, EA VE OVE!�ANG.
BUTTE COUNTY
BUILDING DIVISION
APPROVED