HomeMy WebLinkAbout047-740-003BUTTE COUNTY PARRS DEVELOPMENT FSE CERTIFICATION FORM
CHICO AREA REC��RrEATION AND PARR DISTRICT
Assessor Parcel-Number(s) `l (4C C.) 0
Property Owner i 1 ��_g . ^CiY l f CiY -e rN c�✓'\
Project Location/Address l._._ \ ► LI rr t� 1 t , (�► I
Subdivisionh p �� Sr /� (,1 nl ( f1G.� t 1 Lot Number(s) 3
Residential Development: (check one)
4New Development ' _Alteration/Addition _Mobilehome(s) Non -Residential
to
to Residential
Total Number of Dwelling Units
Comment:
1' zr Ce M\06% rd Wz)
Building Department Representative Date
wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww�r�rw�r*w
Chic`o`;rea Recr a�tron and'Pa`rk" Dist ct(CARD)� certifies" that '
Applicant Name)
Street.Address)
' (City)
State)
(Phonel.Number)
(Zip Code)
has complied with the requirements of Butte Co. Resolution No. 90-140 by�
payment for dwelling units @ $1,189 for total payment of
CARD Representative
PAID BY CHECK NO. � REMARKS:
BANK NO.
PAID BY CASH
RECEIPT NO.
Distribution: White --Applicant
Pink --CARD
park.fee (form revised 11/90)
aa- - 6 --
Date
11/22/02 #8662 11:13AM RMITAL $1189.00
Yellow --Butte Co. Building Dept.
Goldenrod --City of Chico Building Dept.
t,
c
School District
A.P. Number
Property Owner
Property Location/Address
Subdivision
BUTTE COUNTY SCNOOL$JMPACT FEE CERTIFICATION FORM
(One form per Building)
� Cit S--"', ��` •
Building Department No.
*4 Jurisdiction: City ' County
Representative
Lot No.
-aLo
:.................................................................................................................
.r.
I Sq. Footage
Addition/ *Supplemental to (Group R)
Conversion Permit #
'(No foundation inspection):
.................................................................................................................
Sq. Footage
(Including Exterior
Roofed Areas)
r Date
i
u-ioor Plans reviewed Dy Scnool uistrlct Personnel)
Residential Development
No of Living
Mobile Home
Units
Installation
Commercial/Industrial ^
Y
New
Addition
A -,
Representative
Lot No.
-aLo
:.................................................................................................................
.r.
I Sq. Footage
Addition/ *Supplemental to (Group R)
Conversion Permit #
'(No foundation inspection):
.................................................................................................................
Sq. Footage
(Including Exterior
Roofed Areas)
r Date
i
M
(City)
has complied with the requirements of Resolution No.
e70 -%
representing � square feet.
School District Representative
Paid by Check #
Remarks:
e / , e
(State).; � (Zip Code)
by payment of $
-Z�,O�
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 66020(a), 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.xls (10/98)dmm
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