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BUTTE. COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District 1 . (� Building Department No.
A.P. Number O /.5, Jurisdiction: City County
Property Owner C%e 1 G i [� D -yyr e S
Property Location/Address N - - S G� �J e ` Vl 1 C !�
Subdivision As r k Lot No. l
a
......................................... ...................................... :..................................
. // C /
Residential Development Sq. Footage b
No of Living Mobile Home Addition/ 'Supplemental to (Group R)
Units Installation Conversion Permit #
'(No foundation inspection);
........................................................................................ ..
Commercial/Industrial 0
New Addition
Building Department Representative
...
Sq. Footage
(Including Exterior
Roofed Areas)
a Date ;
imoor clans reviewed by 5ch001 Uistnct Personnel)
District Identification No.
SchoolDistrictcertifies -that
(Applicant)
(Street Address) (Phone Number)
r f
i c O
(City) �: (State) (Zip Code)
has complied with the requirements of Resolution No.
representing �6square feet. g
School District Representative
Paid by Check # Remarks:
02 ! U ! jJ by payment of $ 2�fZ�(i�Q U
r
AB 2926 $
FULL MITIGATION $
Date
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),
this project may 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.xis (10/98)dmm
!r
BUTTE COUNTY PARKS DBVZI.OPMZNT FEB CERTIFICATION FORM
CHICO ARBA RECREATION AND
PARK DISTC;RICT
Assessor Parcel Number(s)
Property Owner
Project Location/Address 1
Subdivisionsu ;12Gc �!_ :•ot Number(s) /
Resident' Development: (check one)
New Development _Alteration/Addition _Mobilehome(s)
Total Numberetf Dwelling Units 0/t%�—
Comment:
Building Departmen Representative Date
_Non-Residentia
to Residential
**************************************************************,or, II******
Chico/ Area Recreation and Park District(CARD) certifies that
em
(Applicant Name) (Phone Number)
> X -1 —IT -
Street Address
,/7i
City)
A-
S J /-
(
(State)
Zip Code
has complied with the requirements of Butte Co. Resolution No. 90-140 by
00
payment for dwelling units @ $1,189 for total payment of $
I LJ O O
ARD epresentati a at
PAID BY CHECK NO. REMARKS:
BANK N0. aS
PAID BY CASH
RECEIPT NO.
Distribution: White --Applicant
Pink --CARD
park -fee (form revised 11/9n)
Yellow --Butte Co. Building Dept.
Goldenrod --City of Chico Building Dept.
07/05100 i0.1 -90I 00101099
C. L.T! X11°9.00
WINESAP CT -..�
1=40'd'
PLANNING DIVISION- BUILDING APPROVAL
Use: 01 Date:
Parking:—
Landscaping'—
other-
PLANTERS
SWIM OUT
A
APPROVED
Butte !County
Env?ronmental Hca,%h
Dates
Si nat
ALL Si FWarUA AND 15OUVAENIf ISN U '
OVERHANW SHALL EE CL:iE AR OF ALL 15"EMEWIM,
A SEI` BACK OF ��... pT, E6A069 IM- ANIJ
ET. PAW THE AIRIA P`FIOPF-Afy U14E ANIY
r --r, mi PiE ROAD CENTE-AL114E SNALL.-O
CLEAR OF STRUCTURES, AND EQUIPMENT
*OR A 2 lam'. EAVE OVERHANG,
GENERAL SPECIFICATIONS
SIZE 24 x 40 AREA 7 56 DDEPTH "� &ITO 7'0
SHAPE CU S -To M PERIMETER 11 O
TEMPLATE NO. CUSTOM-
I TILE SIZE 6 "' x
TILE COLOR 0 T S
COPING N 0
COPING COLOR N O
POOL CAPACITY 31 ( 0 0 GALS.
PUMP CAPACITY 110 G.P.M.
MOTOR H.P. 2 H.P.
FILTER 48 SO. FT,
FILTER RATE 1 1 0 G.P.M.
TURNOVER 1; HRS.
VACUUM LINE & SKIMMER
RETURN LINE 2 "
MAIN DRAIN 1 1/2
SKIMMER - MODEL U-13
BACKWASH To D I S LINE
3n ' OF %" FILL LINE
ANTI -SYPHON VALVE 6 U T Q F I LL
HEATER N 0 SIZE N 0 BTU
GASLINE BY: N 0 VENTED BY: NG
LIGHT 00 (W)
CLOCK 2 Z 0 (V)
ELECTRIC BY: C F P
ELECTRICAL BONDING BY: C F Q
POOL CLEANER POO L VAC
CHLORINATOR NO
BOARD -SIZE N 0 COLOR N
BOARD SUPPORTS- NO
LADDER -Model NO
SLIDE-{I__LL_0_ coior N___()_ -:- .:-
0 YES
RESIDENCE A n n v s n STUB PLUMB MN 0
OWNER:00,s,
1rtvf__
TO DETERMINE APPROXIMATE ELEVATION \NOTE SCG StAL 118„
#4_^1CAle
OF POOL ON DAY OF EXCAVATION.
OWNER: PEB8LE TEC
POOL AREA TO BE FENCED, PER COUNTY
OR CITY ORDINANCE. GATES TO BE SELF
CLOSING AND SELF LATCHING.
BY OWNER
OWNER:
WET DOWN CONCRETE SHELL AT LEAST
TWICE DAILY FOR 1 DAYS.
DO NOT TURN ON POOL LIGHT WHEN POOL
IS EMPTY.
DO NOT USE RUBBER HOSE WHEN FILLING
POOL AS IT WILL MARK PLASTER.
TILE & COPING SAP 0 oTN
DECK BY: C F p
TREES, ETC. N
PERMIT OFFICE CONCRETE REMOVAL BY: N 0
SALESOFFLOE
RAISED
YES O BOND
NO A HEIGHT -MOTH
PHONE NO. MGR.
JOB NO. SALESMAN
MAP BOOK No. DATE SWIMMING POO L
LEGAL DESCRIPTION NAME BUZZ AND CAROLYN
-Ap 47-680-019 OWN. BY ADDRESS 13847 WINESAP CT,
CHICO CA
LOT N0:
CK'D. BY
CROSS STREETS -
TRACT NO. RES. PHONE 345-2.743 BUS. PHONE
-
BOOK PAGE BLOCK
MAILING ADDRESS PRINTS CARE -FREE POOLS
S_ #9 Alyssum Way
Chico, California, 95928
I C Bill Bell
Contr. Lic. ##380826 Phone 342-4639
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