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BUTTE COUNTY SCHOOLS IMPACTFEE CERTIFICATION FORM
(One Form Per Building)
School District Building Department No.
A.P. Number Jurisdiction City �ounty
Property Owner /0W -9X
Property Location/Address
Subdivison Lot No.
Residential Development
Commercial/Industrial
k Bui���—partmentg De
No. 6f Living
Units "
0 Sq. Footage Z8W
MHI Addition (Group R)
Sq. Footage
New Addition (Including Exterior
Roofed Areas)
' Date
(Floor Plans reviewed by..School District Personnel)
District Identification No. 9�� l S �C6U 1f Lo s
Cb 0,4 191 School District certifies that Tl Qn
4
(Applicant)
(Street Address) (Phone Number)
(City) (State) (Zip Code)
off/ O�
has complied with the requirements of Resolution No. S% 9 / / by payment of $
representing square feet. Check here if fee received represents "Full Mitigation".
School District Rep
Paid by Check # Remarks:
Bank Number f14, — .202
Paid by Cash
Date
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
r 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.wkf (a/ea)
t
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BUTTE COUNTY PARKS DEVELOPf:FEE CERTIFICATION FORM
't CHICO AREA RECREATION AND 'PARK DISTRICT
Assessor Parcel Number (s) Q % - Q - Q q 7
4` Property Owner �, . y� V Fri u) h •t s
Project Location/Address I U l
ffe! vLot Number(s)Subdivision
r �.
Residential Development: (check one) "
New Development _Alteration/Addition _Mobilehome(s) Von -Residential
A yS to Residential
Total Number of Dwelling Units _
Comment:
Building epartment Representative Dat
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'4.*,•Chico'Area Recreation and Park District(CARD) certifies that
R o_ra
(ApplicantName) (Phone Number)
Ci11Co �4 Croom() q E.c, v¢.,r\vQ-
(Street Address)
ChtC3� Cit G SG3(,o
(City) (State) (Zip Code)
w
has complied with.the requirements of Butte Co. Resolution No. 90-140 by `
payment for dwelling units @ $1,189 for total payment of $
r
CARD Representative Date
PAID BY CHECK NO. REMARKS:.
BANK NO. C(0-ya0;)- /IaI
PAID BY CASH'
RECEIPT NO. (a-7-70
Distribution: White --Applicant Yellow --Butte Co. Building Dept.
Pink --CARD Goldenrod --City of Chico Building Dept.
park. fee ( form revised 11/90)