HomeMy WebLinkAbout047-740-017• ;w;x^S!l�4fl.,F�"T SF''11`. ;5� "r'pi' �. .... ,.''�.. .a' Y� � r ti�Ss ri..i" ;7;c.� _... � �,r ..
` ) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
' (One form per Building)
ONSchool District Cz Building Department No.
A.P. Number r CI;-�G' �� T Jurisdiction: city County
Property Owner
Property Location/Ac
Subdivision Lot No. l
.......................................................................................................j. ....., 1 �/� � "+•�
Residential Development 11 / . ,.-S Footage
No o Living Mobile Home Addition/ 'Suppiemental'to / �-�''(Group R)r
nits Installation Conversion Pepity
(No foundation uispection)
,.+
........ ............................................�.... p, ...............................................
E M '
Commercial/Industrial ~I Sq. Footage
New. Addition (Including Exterior
e ww Roofed Areas)
Building Deparllm6nt Representative Date
(rIOOr mans reviewea oy Jcnooi uistrlct rersonnel)
District Identification No.
School District certifies that
� (Applicant)
(Street Address)
! 0
(City)
has complied with the requiremennttss of Resolution No.
representing / square feet.
School District Representative
Paid by Check # Remarks:
(Phone Number)
(State) (Zip Coder
by payment of $
AB 2926' $
FULL: MITIGATION-- — $
r"
/A.2
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 (70/98)dmm
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