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HomeMy WebLinkAbout047-740-010BUTTE. COUNTY SCHOOLS IMPACT; FEE CERTIFICATION FORM k (One form per Building) t» School District r% (11Vr) ( )� Itt PC-,( ` ��_ 0,,�'� Building Department No. A.P. Number nty (J '(J�9 Jurisdiction: City County Property Owner Property LocatioNAddress Subdivision t --h ESA 64 L Ayilll ✓%q #: lot No. # t q V .................................................................................................................. CZ Residential Development 0 Sq. Footage 115 t, No'of Living Mobile Home Addition/ *Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection): ................................................................................................................... Commercial lndustrial Q New, Addition Building (Floor Plans reviewed by School District. District Identification No. Off/ 75 Zo School District certifies that Sq. Footage (Including Exterior Roofed Areas) Date , (Applicant) (Street Address) _ V // (Phone Number) ' (City). has complied with the requirements of Resolution No. representing square feet. �•r (State) (Zip Code) by payment of $ 673 So? /, AB 2926 $ FULL MITIGATION S School District Representative Date 3. Paid by Check # -.9, -% '- Remarks: .3' 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 660201x►, 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 ICEQA), 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 BUTTE COUNTY PARRS DEVELOPMENT FBS CERTIFICATION FORM CHICO ARBA RECREATION AND PARK DISTRICT Assessor Parcel Number(s) 17 / � —�fy� Property Owner Project Location/Address G04l eti, a, Pki,('06 Subdivision � - ��A►�r �l�n�l n� . Lot Number (s) 14 J Residential Development: (check one` ✓New Development _Alteration/Addition _Mobilehome(s) _Non -Residential to Residential Total Number of Dwelling Units Comment: Z iiilding Depaitment presentpti Date rhirn Arca RprrPAt_inn-an'( Park nistrict(CARD) certifies that (Street Address City State) Zip Code) N, has complied with the requirements of Butte Co. Resolution No. 90-140 by Ipayment for dwelling units @ $1,189 for total payment of $ � �_ CARD Repress�eenta``tive Date PAID BY CHECK NO.REMARKS: BANK NO`" Ci' qaO,Z�-I PAID BY CASH RECEIPT NO. Distribution: White --Applicant Pink --CARD, park.fec (form revised 11/90) M/20/M #5854 1.0:09AM - FXXTOTAL $11$9.00 Yellow --Butte Co. Building Dept. Goldenrod --City of Chico Building Dept.