HomeMy WebLinkAbout055-310-010BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BPO5007,0
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of per/•ury that I am licensed under
Issued Date: 04/25/2005 APN: 055-310-010-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
Site Address: 4646 PENTZ RD PAR
License 'Class: License Number:
Map Index:
Date: Contractor:
Description: NSF (3368) GAR(884)COV(91)OPEN(576)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: TAGGART LANCE &LAURIE
permit to construct, alter, improve, demolish, or repair any structure, prior
PO BOX 2169
to its issuance, also requires the applicant for such permit to file a
PARADISE, CA
signed statement that he or she is licensed pursuant to the provisions of
the. Contractor's State License Law (Chapter 9 commencing with Section
95967-2169
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and.the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees.with wages as their
sole compensation, will do the work, and the structure is not
Applicant: TAGGART LANCE & LAURIE
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
PO BOX 2169
owner of property who builds or improves thereon, and who does
PARADISE, CA
such work himself or herself or through his or her own employees,
95967-2169
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
I, as owner of the property, am exclusively contracting with
licensed
contractors to construct the project (Sec. 7044, Business
Contractor:
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License
❑ 1 am Exempt under Article usiness an rofessions Code
Date: �-?" /
0 er:
License #:
WORKERS' COMPE hSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer: HUBLEY, MICHAEL D.
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 4919 S.F.
Valuation: $247,352.00
��y #.
Census Code: 3�
.._Pol►►
1Q/ I certify that in the performance of the work for which this permit is
(l issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
�
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is reby iss d and he ap li ble pr isions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolution o do wo i dica above or hich es have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By:
Address:
(Date:
PERMI XPIRES ON:
(Date)
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the dujy authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any o,04a1 form or do l o€.@aite County. I hereby
authorize representativesof Butte County to enter upontheabovementioned property for inspection purpo
Print Name: (��Z�i�+P t Signature:
Date:
Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
l
5-OCJ12D
'�-5he��C�.
7 774
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL•BE REQUIRED AT TIME OF APPLICA TION .
Website: www.buttecounty.net/dds
•
"PLEASE PRINT CLEARLY * *
OWNER
Last Name _
Name
First Name
Address • — -7 -7fZ
City
City
State
State
h't� %7- L' �
Phone
Fax 77 - 00?D
E-mail
E-mail
ARCHITECT/ENGINEER
CONTRACTOR
Name
Address 3 Y,
Address
City, is �,
City
-
State
tip
Phone
� 3L% 1q. l b -
Fax
E-mail
State Luse Numbat
Lic. #
Class
ARCHITECT/ENGINEER
Name
v�
—
Address 3 Y,
Jte, Lin Le) Al -e—,
City, is �,
Zi
to
Zi 10
Phone.
7 4o
� 3L% 1q. l b -
Email
Planner
State Luse Numbat
APPLICANT NAME
Name
Property Address q&4(p QiyZ fW,
Address .-
City
9<
State
e A
Zi
Phone 7
Fax 7-7` 46)% v
mail L
�/.. uL .�/�? T �.. lci��SjC-7
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/•G.�7c1/. /�l.L�
APPLICANJ-SIG E
X
For office use only: I
Zoning
Property Address q&4(p QiyZ fW,
Flood Zone
Cross Street
SRAYes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
Bpo-D070
BIN # A , j
LOCATION
AN
C7SS-- 3/49 -
Property Address q&4(p QiyZ fW,
Cit
7�G�u-�
Cross Street
e s
WORKER'S COMPENSATION
Policy Number
Carrier
hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
(Note previous use):
LENDING AGENCY
Name
Address
Description or Scope of Work:
�jt� i I r✓\ 40�vl�
Sq. -2, (o v lkiZ
e s
❑ r Str c ure14 'It without Permits
j
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
OVER FOR SUBMITTAL KF_QUIKtMtN 15 L`
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Received b : Amount: � S03 Bldg
SRA
Receipt #:q/ 1 /0
Sheriff
/ SMIP
Date
/�ib/o5—
Total
REV 7-27-04
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit.
INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑
1.
Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑
2.
Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations,
❑
3.
Engineered truss details and layouts in duplicate (if required). No faxes!
❑
4.
Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to
mobile or modular homes.)
❑
5.
Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑
6.
Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑
7.
Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor _
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑
8.
Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑
9.
Site plan and business license approval from the City of Biggs.
❑
10.
Letter of intent for non-residential buildings.
❑
11.
Detached Accessory Building Form filled out by the owner (if required).
❑
12.
Hazardous Material Form (for Commercial Buildings only).
❑
13.
Sanitation and site plan approval from the Environmental Health Department.
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning '
review
(May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). f
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530)538.7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\61dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04
a
Applicant: Taggart, Laurie Permit 05-0070
Project Type: NSF/Cov/Gar APN: 055-310-010
100% 70%
Plan Check Fees $ 1,503.33 $ 1,052.33
$ 1,503.33 $ 1,052.33
WILLDAN Fee $ 1,052.33
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
Butte County Department of Development Services uT r
1
YVONNE CHRISTOPHER, DIRECTOR ° 0 0 o
O
o
7 County Center Drive o
°
Oroville, CA 95965°
c�U
(530) 538.7601 Telephone N'�y
(530) 538.7785 Facsimile
0
0
TO: WILLDAN
'
Tom
FROM: Scott Rutherford (530) 538-7160
srutherford(@buttecountv.neLO t
SUBJECT: Plans Transmittal For Review Per Contract
O
DATE: 1/12/2005
Applicant: Taggart, Laurie Permit 05-0070
Project Type: NSF/Cov/Gar APN: 055-310-010
100% 70%
Plan Check Fees $ 1,503.33 $ 1,052.33
$ 1,503.33 $ 1,052.33
WILLDAN Fee $ 1,052.33
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: 71f7Vy;71 ASSESSOR
PARCEL NUMBER
Proposed Building Use: qV /f-- Counter Technician: t Date: U �}
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. /
1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
K6. Energy compliance design and supporting documentation in duplicate.
O 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑ 11. Site plan and business license approval from theCity of Biggs
❑ 12. Letter of intent for non-residential buildings# f'
❑ 13. Detached Accessory Building Form filled out by the owner
14. Hazardous Material Form+
15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
❑ 16. Other
Rerr�iniIn' ems needed to issue the permit. (May require additional plan review,upon receipt of the following items.)
Fire Sprinklers.................................................�-......... .4 .....
. ` ❑ Agricultural Buffer clr and site plan apr from the ,Ag .Commissioner Sent by
❑ 19. Soils Report and/or Engineered Foundation required...... .............................. ........
OErosion Control Plan Required................................................................... ........ is
n Fees as shown on the attached Schedule of Fees Due Sheet ..............................
\ ❑ 22. City of Chico Plumbing permit........................................................................
2 California Department of Fokabut
y plan approval ❑ paid. epi . / / . - o.� 5 F
24 lanning approval (A) Use:(B)Parking: (C) Parcel Check:-
25.
heck:
25. Contact Land Development Im rovements Draina e .........................
P- P 9
❑ tj 27. NPIDEncrS Form.,.
ori,......................................................
T Permit for driveway from the Public Works Dept ...........................
❑ 28. Pre -Inspection for ell, required....,..
❑ 29. Contractor'slicense information. (Number, Name Style, Classification) ...................
❑ ' 1 30. Worker's Compensation Carrier and Policy Number ..........................................
�E7)N 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑ �32etter of Signature authorization......................................:............................. t�
33. ecorded copy of Agricultural Acknowledgment Statement'.*..
tatement.................................
❑ 34. Manufactured home utility clearance...............................................................
❑ 35. Existing violations and/or expired permits.........................................................
❑ 36. Deed Restriction......................:...................................................................
❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement•of,Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
�❑ 38. Other:--�
❑ 39. Other:
When issued Telephone and hold for pickup.
I have been informed Athe above it�.a ijg�e uixements for obtaining a building permit.
Applicant: !Jt u X a e: 1-h0 - G5-
1. Index permit ap4dtionfor the above ite s nu bered: Plan Check Letter
2. Additional items required
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:__ '
Structural reviewed �: _ Date: Structural approved by: i Date:
Note transfer by: Date: 6 0
Yellow: Building Division
E.H. USE ONLY
Piot Plan Attached
Float Plan Attached YC
Sons to S.D. / p
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
%as�o 2171 Z Lam' SS -3/d -616
n e r Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public X Private Well
Clearance for dwelling. Other xe,,, e w��P
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist
8/96
/Z -ZZ -0�-
Date
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541
SCHEDULE OF RECEIPT OF FEES
OWNER
PROPROSED BUILDING USE N 5F
1. BUILDING PERMIT FEES
--- Balance Due .....................
$ z 2- 5S-40tb
A.P.
DATE
RECEIPT # DATE REC.
--- Additional Fees Due........... $
O�Revised Plan Checking Fee.... $rio
2. SCHOOL DISTRICT FEES~7"� 9r
(paid at School District Office) (form available after Plan Check)
_e SHERIFF FEES (paid at Building Division) �7
Residential............ X $360.00 =$ �b// � �� 2c� Z < G
Units
Commercial (sq. ftg.)..... X $0.03 = $
Sq.Ftg.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit)..... X = $
# Units Amt.
Commercial (Sq. Ftg.).... X = $
Sq. Ftg. Amt. nn
5. RECREATION DISTRICT FEES �'IY)I-K gt;eO
(paid at Recreation District Office) (form availab a after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
$5 (paid at Building Division)
\ 7. SRA FIRE INSPECTION AND PLAN CHECK FEE
499+0 -(paid at Building Division) (_Iq
2
8. WATER TENDER FEES BATTALION #
$200.00 (paid at Building Division)
9. NORTH CHICO SPECIFIC PLAN (paid at Building Division)
Residential Zone X = $
Zone # Units Amt.
Commercial (sq. ftg.) ......... X = $
Sq. Ftg. Amt.
t/ 10. OTHER � � � F> yd
N-762% Y^Z S�o s—
At time of permit applicatio I as advised thea fees are required to be paid prior to issuance of the permit. These fees
may be changed durin
APPLICANT DATE `(6 -0
Pursuant to Govemment E e Section 66020, yo�jbeby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You
have 90 days from the date of approval of the pfrom the imposition of the above mentioned items during which you may protest. The requirements for a
protest are specified in Government Code Section 66020(a).
Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) 0
O2 BD �., RI-sIO
�§i'e"SA.o: Y4.5S�6 5,:'n.iCk.anF�:v.a;+'nna f'e......5._'`L::.R•SE+TSN,_ cn.s's, J, icy N6 . STat+,
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary
delay in processing and issuing your building permit. No building permit will be issued until this
verification is received. .
1. I personally plan to provide the major labor and material for construction of this proposed
property improvement: YES[ ] NO[ ]:
2. I HAVE [X ] HAVE NOT [ ] signed an application for a building permit for the proposed
• work.
3. 1 have contracted with the following person (firm) to provide the Proposed construction:
NAME:
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTY OWNER:
DATE: < --/0—
NOTE:
fD—
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
Rev'd 11 /4/2004
Butte County Department of Development Services
ADMINISTRATION ` BUILDING' GIS ` PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538.7541 Telephone
(530) 538.2140 Facsimile
NUNN �a2)tm�'alc�s:a,
s �._..bT'I -..�•F r > a : �. : V` &�
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
pen -nit. Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government as an employer and you are subject
to several obligations including state and federal income tax withholding, federal social security taxes, workers'
compensation insurance, disability insurance costs, and unemployment compensation contributions.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
cerely,
Mic el C. Vieir C.B.O.
M ager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
O�QPRTMEN7-
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CLIC y�/Ovk
Department
. C o u n t
J. Michael Crump, Director
Public
f B u t
Works
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE]
Project Description: N 5 F
Project Location and/or Parcel Number: –5/6— 0/0
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law. n
Signed:
Title:
Date:
1—to- os- .
Less than 1 Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
. Revised 5/24/04
SWI LLerving IDA�N
March 22, 2005
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
Tel: (530) 538-7169
Fax: (530) 538-2140
SUWECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL
117 C Street
Marysville, California 95901
530/749.2373 fax 530/749.2199
www.willdan.com
Willdan Project No: 14353-1338
Jurisdiction Job No: 05-0070
Applicant: Lance Taggart
Description: Taggart New Single Family Dwelling
Dear Mr. Rutherford:
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the -2nd page of this letter. The revisions were in
response to a previous plan review and comments listed in our letter dated February 9, 2005. The plans
and documents provided for this review that have been found in compliance with the applicable codes are:
• Plans: Two (2) copies sheets & 1 through 5 dated 3/3/05, and revised sheet 6 dated 12/14/04, by J.
Peppler Designs, and sheets SN dated 3/3/05, SD1 and SD2 dated 06/30/04, by Ver -Tech
Engineering. k
• Structural Calculations: Two (2) copies cover dated 07/14/04, by Ver -Tech Engineering.
• Energy Calculations: Two (2) copies dated 07/14/04, by Robert A. Mangrum.
• Truss Calculations: Two (2) copies dated 07/09/04, by Design Assistance.
• Miscellaneous Documents: Two (2) copies CDF Fire Safe Requirements. Two (2) copies Truss
Calc letter dated 7/14/04, by Ver -Tech Engineering.
The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to
our previous letters relating to this project, the superseded plans and documents will be discarded within, 10
days unless we receive other instructions.
On the pages to follow is the identification of the codes and standards applicable to the project, a code
analysis, conditions -of -approval and identification of any deferred submittals.
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24:
• Part 2, known as the California Building Code and abbreviated herein as "CBC".
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC".
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC".
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC".
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS".
CODE ANALYSIS
Our plan review revealed the following information regarding the occupancy designation, type of
construction, and other pertinent features. This information is not consistent with that shown on the
permit application.
Type of
Occu anc
Type of
Construction
Sprinklers
r�
1" Floor
Sq Ft
2 nd Floor
Sq Ft
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24:
• Part 2, known as the California Building Code and abbreviated herein as "CBC".
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC".
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC".
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC".
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS".
CODE ANALYSIS
Our plan review revealed the following information regarding the occupancy designation, type of
construction, and other pertinent features. This information is not consistent with that shown on the
permit application.
Type of
Occu anc
Type of
Construction
Sprinklers
Stories
1" Floor
Sq Ft
2 nd Floor
Sq Ft
Total Sq
Ft
R-3
V -N
No
2
1235
2133
3368
U-1
V -N
No
1
*
0
.,,95fr—
Cov. Porch
V -N
No
1
0
91
91
Deck
V -N
No
1
0
*576
*576
CONDITIONS OF APPROVAL
1. Approval is contingent upon the review, requirements and approval of other departments
and/or agencies that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
3.. *Permit application building areas specified in the scope -of -work shall be reconciled with plans
to Butte County's satisfaction.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals noted at this time.
SPECIAL INSPECTION NEEDS
Our plan review -reveals no special inspection needs pursuant to CBC 1701.
IIIIIIIIIIJIgg
Michael LeBeau - Ricardo Guzman, S.E.
Plans Examiner Structural Plan Check Engineer
Cc: E-mail Alice Mefford at: amefford@buttecounty.net
Ver -tech Engineering, 383 Rio Lindo Ave. #200 Chico, CA 95926 Fax: (530) 899-1102
Laurie Taggart, 5780 Pentz Road, Paradise, CA, 95969 Fax: (530) 877-0870
Papel of? WHIdan :14353-1._ 38.PC2.1:
Butte County 05-0Q70
STATE OF CALIFORNIA—THE RESOURCES AGENCY ARNOLD SCHWARZENEGGER, Govemor
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
Butte Unit
176 Nelson Avenue
Oroville, Califomia 95965 .
(530) 538-7111
April 24, 2005
RE: APN # 055-310-010 Lindenbaum Lane, Paradise, CA
01
To'Whom It May Concern:
The above named parcel is within 1000 ft. of a fire hydrant; therefore, the owner will not
have to provide automatic fire sprinklers' in their home.
Henri Brachais
Fire Chief
By: Steve Fowler
Assistant Fire Protection Planner
Life Safety Officer
L1
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
/, .
School District � �c�• I �:.�C._ Building Department No. 0-500-70
A.P. Number OSS�3 / 0 Jurisdiction: City A,
County
Property Owner
Property Location/Address
Subdivision
Lot No.
Residential Development 4 Q
.._ ....................... _............
Q
...................... :................................ _....
Q S4• Footage
:3,36No
of Living Mobile Home
Addition/
•Supplemental to
(Group R)
Units Installation
Conversion
Permit #
*(No foundation inspection)
a.
....................................................................
. ....... _........... .....,
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial Q
A /" New
Department Representative
District Identification,No.
'. �C/RifslyiY School District certifies that
Ay :.
to ✓ S� U �����Z ��
(Street Address)
11, r
(City)
has complied with the requirements of Resolution No.
representing
School District Representative
square feet.
Paid by Check # / Remarks:
Sq. Footage
(Including Exterior
/ A)Roofed Areas)
t� V�
Date
(Applicant)
.45 '7 7- 3,a �/ Z
(Phone Number)
(State) (Zip code)
by payment of $ 7a0 % 5 ,
2926 $
- FULL MR1GAT10N $
y:
Date
Notice: You may protest the Imposition of the fees identified above by submitting a written protest to the District. In compliance with
cownunent code Section 66020(a), within 90 days from the date fees aro paid. Failure to submit a timely written protest wiil'prohibh
you from challenging the Imposition of the fess In any court &alien.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Ceffl ation Form, the School District is
r
Will by the sppficabis Local Planning Agency -that this project Is being reviewed under the California Environments! Quality Act (CF.QA1
this project may be subject to ad ftmal school fees to fully rnhtipate.its impact on the school district's schools.
White (applicant), Yellow (building department), mink (school district) feeform.xls 00/03)dmm
i
BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM
❑ FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s) Building Permit Number S_Pd % o
Property Owner (s).
Project Location /Address
Subdivision Name
Assessable Sq.,Ftge '336 e
Type o •Residential Development (check one)
New Development Single Family -Detached Single Family -Attached
Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling
Mobile home Mobile home replacement verified by Assessor Department
Demo Permit (date issued ) verified by Building Department
Comments:
❑ FRRPD ❑ CAR_ D/PRPD ❑ DRPD certifies that:
L-Lurl 2. %/� 4 c ci r- - " 377 -- 30 �Z
Applicant Name Phone Number ,
P
Mailing Address City State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of:
Dwelling Units @ $ per unit for a total of $
Z
3 3 Square Feet @ $ o per sq foot for a total of $ _ lz g
l
Remarks:
Paid KCh ck No:
and Park District Representative
Paid by Cash,
X17,/ l l J
UFORMSWILDING FORMS\park-rec standard form rev Ldoc
9
-73 Receipt No: —76
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
ia005--001 9845
Recorded
Official Records
CoBUTyyTE f
CANDACE J. GRUBBS
Recorder
ROSEMARY DICKSON
Assistant
11:52AM 08 -Apr -2005
I REC FEE 10.00
I CONFORM 1.00
I COPIES 2.00
1
I
I
1 Myles
I Page 1 of 2
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date CP (vim -OSS PROPERTY OWNERS:
l.Lu-✓i`e / � c��-v /
a T
UJ
State of Californianr 11 ) t
County of
On �D D Ze-p � before me,
personally appeared / personally
known to me (or pr to me on the basis of satisfa vidence) to be the person(s) whose name(s) is/are subscribed
to the within instr ment and acknowledged tom hat he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signat ire(s) n the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNK5-9--3
d official se
Signatu'
A.P. # D t 0
6P.r
Seal: .9.�°`.'°F, JAMES A. FORREST
r Comm. #1361030 01 9b NOTARY PUBLIC CALIFORNIA Q
COUNTY
4 , > MY Commission Expires JUN. 15, 2006
PARCEL I,
93-36301
PARCEL �, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE
OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON JULY 2, 1993, IN BOOK 129,; OF MAPS, AT PAGE(S) 82
AND 83.
PARCEL II
A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY EASEMENT
OVER THAT PORTION OF PARCEL 9, KNOWN AS STARLIGHT LANE, AS SHOWN
ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE
RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 2,
1993, IN BOOK 129, OF MAPS, AT PAGE(S) 82 AND 83.
i
t }
STATE OF CALIFORNIA }ss.
COUNTY OFt11fr3F f%ucCfn6 } n 1L
U On duly ay, I`I°I20 before me, IC(JlG C Q.,G,,4,t10i .E
personally appeared Frank Konrad and Rosa Ko r�d
C—
personally known to me (or proved
to me on the basis of satisfactory evidence) to be the person(s., whose name(s) /are subscribed to the within
N
LE instrument and acknowledged to me that/9&,/they executed the same in.Ap6r/their authorized capacity(ies),
and that by I4/,Idr/their signature(s) on the instrument the person(s) or the entity upon behalf of which the
person(s) acted, executed the instrument.
e
WITNESS my hand and official
ofiiicial se'a�l.
%
/ Signaturo J
9 M11tD0{/f111
11L Mimi
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
COPS( of Document Recorded
08 -Apr -2005 2005-0019845
Has not been compared with
original
BUTTE COUNTY RECORDER
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations. .
All that real property situate in the County of Butte, State of California, described as follows:
Date 1 CO (a00� PROPERTY OWNERS:
/ r✓ 7 /
State of California ) ,
County of )
On DI 1 1 4i before me, V�; M -e 1,4.
personally appeared "
known to me (or pr to me on the basis of satisl
to the within instr ment and acknowledged to i
capacity(ies), and that by his/her/their signature(s)
the person(s) acted, executed the instrument.
WITNESS my lid and official sq
A.P. #
vidence) to be the person(s) whose name(s) is/are subscribed
hat he/she/they executed the same in his/her/their authorized
the instrument, the person(s) or the entity upon behalf of which
d.
Seal: JAMES A. FORREST
r1 BB
r Comm. #1361030
V : ® NOTARY PUBLIC CALIFORNIA Q
V BUTTE COUNTY 1
My Commesssion Expires JUN. 15, 2006
93-36301
PARCEL '� , AS SIIOWII ON . TIIAT CERTAIN PARCEL MAP, RECORDED IN THE
OFFICE OF THE RECORDER -OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, 011 JULY 2, 1993, IN BOOK 129. OF MAPS, AT PACE(S) 02
AIID 03.
PARCEL I.1
A 11011 -EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY EASEMENT
OVER THAT PORTIOII OF PARCEL 4, KNOWN AS STARLIGHT LANE, AS SHOWN
ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE
11ECUHUER OF THE COUNTY Ol' BU•C1•E, STATE OF CALIFORNIA, ON JULY 2,
1997, I11 BOOK 129 OF MAPS, AT PAGES) 02 Alto 03.
I
U TAI@ vl C -Ir nluu
CWIt1Y W.—11!131i11/1(, ---
� 1,,,. v,•o�4 w,,.o.•vl _.__rrcu,Y... Yr_a u�oa Lll'J .1'UJU .rtiltl0(1 .._. _ _.. .... ............-.-.—_---'
( ~
111 f( l.rrr .,.r•:.lu, ..:uw:. w pn,•nul
•� IV r•w V• N.q IM19 r.l f.dyr..•.Irr,r....lrr.r n. I"r 1 Ir• ...r y, nb .. ..'1r, r. e....•:v/.,H.•r:lwn
... 1.. 1•l M1r11 n1:
r•.Y J..r. w'•J w.. ..n.•I �.nl 1•. .. 1•...��. �• . .. ..I 1•... .r • //. 1•• ..1••:
w .1 1'•w1 1.1 � � /•. • .� ..1.. n .. / 1•.. .,1.. .. 1 1 .. 1.. / .,: .. Ir.. .... 1 •.1... li: ::I .. I..
i ►GOOD.[ �D11. HAWTHO("
e'
l V., 11,1 DD ... ••1 .r ..l ./.... r CO%" 09"6u
"=MY RAIW • off. TONGA
w.«+lo.a, Down
► SITE PLAN=W APPLICATION
Date: �' '� _v q AP# 0 J6S 31Z9-010
Permit Number (if applicable) Bin Number I _
APPLICANT INFORMATION Parcel Size:
-� --�-f
Owners Name: 44-42CAEL TA- G 6, 11A -0..r
Owners Address: g0 A-EAJ_T7_ ILDI
Telephone No.: 112— _q19 �64 Email:
' Situs Address: �_O j � �—/_i(,Di1LJ6i4-V1 n /Q
Proposed Use:
r
Res'dential -
[New Single Family Residential
❑ Single Family Addition
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family'
Non-residential
❑ New Commercial
❑ Commercial Addition
New Industrial
❑ Industrial Addition
.Other
® Septic
❑ Agricultural Exempt Building
❑ Other:
❑ Single Family Remodel
RUTTE "I
COUNTY
SEP 2 8 2ol4
IDEVELOPAi .u,yr
SERVICES
Commercial Remodel
❑ Industrial Remodel
❑ Well
❑ Agricultural Buffer Form ❑ Applicable ❑ N/A
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
JR Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
If Site Plan Stamped Approved
BYA4 L Date oZ
Pagel of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
® Snow Load Area: SAD D
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
Expansive Soils (Test for expansive soils and if verified proper foundation design required) v/ /
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
• Flood Zone: X
• Flood Panel No.: 61, 60 ZCO5`7 G Index Date: Q
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
❑ Oroville Enterprise Zone
Use Requires:
❑ Use Permit
❑ Minor Variance
❑ Minor Use Permit ❑ Administrative Permit
❑ Variance
----------------------------- ---------- ------------ ------------- --------- —------- -------- ------- --------------- ----------
❑ Detached Building Use Form ❑ Encroachment Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning:""
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. - ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
Side
�Q
Side Street
oZ0
Rear
Height
rWaterway I
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. - ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development Fees:
Standard Fees Amount Formula
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
'❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Drainage Area
❑ Thermalito Urban Area
❑ Other
-----------------------------------------------------------------------------------------=-------------------------------
Subdivision Map Special Fees
❑' Water Tender
❑ Road Iinprovement
❑ North Oroville Area
❑ Other (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit
Parcel Created By
ee s:
Date of Creation: Legal Access Provided: ❑ No El Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation
❑ Obtain a Certificate of Compliance/Notice of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Page 3 of 5
Subdivision Map/Parcel Map: TS
Map Date of Recording: T .ZA5 p p�
Lot: Book: aZ 9 Page: V r3
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
Parcel Map/Subdivision Map/Use Permit Conditions
❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for road maintenance, and stop sign maintenance.
0
Page 4 of 5
Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
C:\Larrys\Building Permit Site Plan Reviewl .doc
Page 5 of 5
BUTTE COUNTY PUBLIC HEALTH DEPARTMENT
f Environrne�n �M���.��L HEA.LTH
P. O. BOX 5364C 7 County Center Drive
411 Main Street ,euTrf. Oroville, CA 95965
Chico, CA 95928 JUL1 e 2 6 2004 (530) 538-7281
(530) 891-2727 •�o y• FAX(530) 538-7785
FAX (530) 895-6512
n ,�, � �� „J ttl � "
APPLICATION FOR PERMIT TO CONSTRUCT A TAW -i M06SAL SYSTEM
Owner's Name
Applicant's N
Mailing Addr(
X-1c,tcc
I-leltNCG
•r
Assessor's Parcel No. OSS F/ /0
Phone No. S77- 3 6 `f Z.
1. Construction Site
kstreet and num er or alrection and distance to nearest crossroad)
2. Lot Size ( 0% l,Q�iiCQ� feet x feet Acres
3. APPLICATION FOR:
New system for new building ❑ Auxiliary or secondary system
Repair of or addition to old system ❑ ' New system to replace existing facilities
4. Type of building to be served by proposed system:
❑ Mobile Home (size ) No. Bedrooms Garbage Disposal?
House No. Bedrooms 3 Garbag Disposal? c
Other (Specify) off.- S� '
5. Water supply for premises: (Must be safe, potable water) Community Private Well ❑ Other
Water supply for adjoining properties: Community Private Well ❑ Other
6. WORKER'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3700 of the California Labor Code, which requires every employer to be insured
❑ I have placed on file with the County of Butte a Certification of Worker's Compensation Insurance.
certify that in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to be subject to the Worker's Compensation Laws of California.
7. SITE PLAN TO BE FURNISHED - Draw to scale on site plan the following:
a. Property lines. e. Show direction and approximate amount of slope.
b. Location of all proposed and existing buildings, f. Source of water.
Structures, driveways and parking area. g. Water lines.
c. Location of large trees, rocks, or other obstacles. h. Set back lines and easement.
d. Location of any well, spring, creek or other body I. Proposed sewage disposal system and area for
of water on the,parcel and within 100 feet of property line. replacement.
I hereby state that the information above or attached hereto is correct and true to the best of my knowledge. 1
understand that thepermit must be obtained before any construction is begun either on the building or on the sewage
disposal system, and that a satisfactory inspection of the system is required before the new building or dwelling_ may e
occupied or the s stem backfilled, or put into use. I also understand that a safe potable water must be supplied to the
new building or elling bef n�cy can take place.
Signed r L Owner ❑ Authorized Agent ❑ Licensed Contractor ❑
Date — a� `f (An original letter of authorization must accompany this application
in order for an authorized agent to sign).
FOR OFFICE USE ONLY
Legal parcel? Zoning Use rm't ? Acct s _
Water plans cleared Potable water Receipt No. Amount `t
Comment
App/SewDisposa I Sys/112003
ENVRONMENTA1 i-1EAL1*iH
_)Y
JUL 2 6 2004
BUTTE COUNTY C(DFD
CHICO, CkLil=ORNIP..
AGRICULTURAL BUFFER NOTIFICATION AND/OR
UNUSUAL CIRCUMSTANCES REQUEST
Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This
dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify
unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not
available for lots being created, divided or subdivided.
Owner or Authorized Agent must complete the following and return with the required site plan to:
Development Services Department, 7'County Center Drive, Oroville, CA (530) 538-7601
Name: ace Phone: g 7 7-- 3o Y 2
Mailing Address: 7
E -Mail address
Assessor's Parcel Number. Q 5—S 1-316L6 16 _
Reason you believe you qualify for the unusual circumstances exception:
[oil
re
Date
An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement
(well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone.
SITE PLAN REQUIREMENT: submit 4 copies with this form
Refer to the Site Plan Submittal handout for specific requirements
....................................................................................................................
...............................
nternal Dept. Contact Info:
❑ Env. Health ❑ Planning Building ❑ Other
Contact Person: Phone:
FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING
For Agricultural Commissioner office use only: (to be completed after submittal)
DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS (Building)
Exception Recommended ❑ Exception Granted with the
❑ Exception NOT Recommended following conditions:
Reason/Condiiions/Specific setbacks from adjacent agricultural operations:
Agricultural Department Signature:
Date:
YMC 7/1/03
v
/A q-
\
\
J
W
U
FD. BTO. D.WA .31011
AS 1. 114 PER W 1 I
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DETAIL "A"
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2649.61
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N8e'0r7BE
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B- A• 3'12'46" R• 2340 L• 142.4)07 101,1
P- M79 -3329E 0.33423'
91,}00'
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2282.64' Di�.CL-
1•
0. 6•@6.32'31' R• 20.00' L•JI.OJ
�f
0. 6. 0304'20' R. 1300 L• 90.49186.27.03.41'
E- S/O.Oe•40E 477.63 011
R•330.00' L•136.06'
S- M 79.3529E 0-413.74-
lM tentative map have boa compiled with and 1 own IalsflM that this map 1.
y.6. 0473'52' R. 2300 L• 200.81 W !
0. S14'9.7'17E 407.0177 lf403-1 D.1
]93.84'
T- p 7973'29 -YR
3''2.89'44!00'
IV
EA
LL R•ZO'W' 4!3172',
V- 6.27'(13'41' 8.300.00' L•141.3T
p
IATE 'B"AOLICFORELS
2
27
TO ERVED
AIDPARCEL
11 DE
)I 1e
J- tls'LWO40- 8.2300.00 L•11.60'
43950'
K- 44:3
X. 6.1'0709' R•2540.00' L•49.61'
Y- 6.0.15"!7' R•2540.00' L•11.78'
9.07.3 AC.
WEE OWNERSHIP OiT
PA
P N
F r � 8
I it
AAdAL 9TMd� I
pY�M gtR7
PARCEL 3
9.410 AC.. I
NOTE '6' I
m COUNTY OF OUT
1949 -OR -472
t
_ A 1052.63' R)
687.9f-
370.88' tn) el[m (WEST B 0 D 1"a52 a/
g
90 IJ' STORM DRA, EASEMENT
0 g PER
d 114-819-61
LEGEND
t
yI Fotwo COR. MOM AS SHOW ------------------------- 0 .
FOUID 3/4' I.P. L.S.3634 PER R) 0
SET 3/4' IP. L.S.6373--^---------------------------0
RECORD DATA PERM-P/et-z-----------------------Yq I
-0.3
DEED DATA PER 63-238 ------------------------- 1� 1
FOUND BUTTE COUNTY RA. SPIKE PER Ot 1 ------------ 7
gAECCCpEpSpS RIGTHTS DEEDED TO :9WTE CO. A"
RETARD Oa TA � RSI 9�2.3738800.E -A' 1 Wd
NOTE 'A' 0ls/�1apnsnpAare hem redone tpow4oad dlslentes or
1. 10060667 I ob 4Ie el.fma.+ex 1
divide by
FMI I/Y' I.P. RCE. 24666
AS CEM SEC PER CR I IR, II
- - V
67.34'
EMENT
)TILITIES
I
7CELtl I
CA710N
PARCEL 4
57.094 AC.
e
CPEM20 P
VV��
/A q-
ROAD
x STARLIGHT
11 B ealte la e. kd m so•elDod In RSA 92-73888
J
W
U
-
5g
K
alp..
/triol/ o/ w®• per
qN
DETAIL "A"
�o
lad
"
ACCESS OPENING PER RSN 9273898
map. It or. The wonums0le .hewn hereon ..let --.
��qq
ryy
NOTES
Bels of Worinm is IM Wly. bAy o/ IM S.W.I/4
as AVO'234110a perO7 1
Dbrlanw. shown ars memecW on,
n rAewn elhelwlre.
NOTE "B' Aents r14ds alma PatrReod have been deeded to
/A q-
11 B ealte la e. kd m so•elDod In RSA 92-73888
This map wa. prepared by me or under my direction and 1. bowed upon o field
;f g
TM --I loawflae o/ ft. .moms
/triol/ o/ w®• per
local drdlnpnce of the request o/ ATTMA KASZA -
BJ -UA -238 II net J.flaed al rat
lad
"
map. It or. The wonums0le .hewn hereon ..let --.
Ono Oro of the character and occupy the position. I
iwdiratod lad me sufficient la enable the whvr
0 R/W 6 E DAT4
to be otroc.d.
' A- 6 .03'23'44' R. 1460 L. 87-8 W 1
0- 6.27.05'41' R.270.00 L•127.68-
9
B- A• 3'12'46" R• 2340 L• 142.4)07 101,1
P- M79 -3329E 0.33423'
•
ppp�
4
C- 6. 00'7649' R• 1160 L• 13.00M Milo,)
0. 6•@6.32'31' R• 20.00' L•JI.OJ
�f
0. 6. 0304'20' R. 1300 L• 90.49186.27.03.41'
E- S/O.Oe•40E 477.63 011
R•330.00' L•136.06'
S- M 79.3529E 0-413.74-
lM tentative map have boa compiled with and 1 own IalsflM that this map 1.
y.6. 0473'52' R. 2300 L• 200.81 W !
0. S14'9.7'17E 407.0177 lf403-1 D.1
]93.84'
T- p 7973'29 -YR
3''2.89'44!00'
�/ ere roma
/4 6. 01'0779' R• 1200 L. 2222 W I
LL R•ZO'W' 4!3172',
V- 6.27'(13'41' 8.300.00' L•141.3T
p
se �r7
I- M873Y9E 40.00'
W- NIO'08'40'W 78.13' IJB22 0.1
)I 1e
J- tls'LWO40- 8.2300.00 L•11.60'
43950'
K- 44:3
X. 6.1'0709' R•2540.00' L•49.61'
Y- 6.0.15"!7' R•2540.00' L•11.78'
Yw
'
L- p 370'10" R.30M�330.00' L•216.00'
W110-
At- .3•3770'10" R.300.00' L•1%-6'
of the request of LeL SURVEYING ,
-
I
w 6•]7']0'10" 8.270.00' 1.178.77'
36 31
2440.00 m 1
230
P le
I
IF0.
SOO 2976-W 262230 ft 1
1
L f
STD. D.WA AWT" AS
SW, COR SEC 31 PER O7 1
Sheet I of 2 Sheet(s)
OWNER'S STATEMENT AND ADDITIONAL INFORMATION SHEET
Am OwneA Sfatepen/ else Ad1117.nd Infamwuitso shhe•/Ip fel .flu hq
fill. hol
R -der of ado. Case
ander Recorder". 6er/at hie 473-Z>9r2v end mMr R.... 'Y
$.Ilei Ah p..p.art..y.
A.P NO. 51-031-004 PTR
PARCEL MAP
,OF PHASE II FOR
ATTILA KASZA ET AL
Being a portion of theS.W.1/4 of
Section 31 -T.22 N. R.4 E.-M.DRek
SEPTEMBER, 1991
Butle County, Colifornia
1
FD. " O.I.P. AS L A L SURVEYING
FD. I COR PER W
1007 BIL e c ROAD 4 PARADISE, CALIFORNIA 968600871
(816)8774687'/ (81 W 877.1300
Job 14x0043-097
/A q-
SURVEYOR'S STATEMENT
This map wa. prepared by me or under my direction and 1. bowed upon o field
veer Ncon/o"ra"te with the Ie4efrus enl. or the Subdivisions Atop Act and
local drdlnpnce of the request o/ ATTMA KASZA -
d.r1n0 ..SEPTENRA_ /9 g, 1 hweDy .fOf1 Ilial ilii, trorcat mop
wb."nt1011f conforws to the approved or condltlonollr approved tentative
map. It or. The wonums0le .hewn hereon ..let --.
Ono Oro of the character and occupy the position. I
iwdiratod lad me sufficient la enable the whvr
to be otroc.d.
Scale 1"- r•zoo•
� � „• `` T,pl sr
9
!gLLl6 L. LUNY lS) 6373
VV
COUNTY SURVEYOR'S STATEMENT
I Amo esmnfned this mtp and 11 Is 'Welaf/alry the tone m It appeared an tbq
fsnfa/lve map and any louvered allo"lla ther•et. All of IM pre/dare of 1M
Sled/.Isla Aho Ael and local mdlears- oppi)-lite of fib it- at eppa•ao of
lM tentative map have boa compiled with and 1 own IalsflM that this map 1.
•
t.chifcally, correct. Tie 60 het roadwq saaemrnfo shown hereat and offered
fur aidladla 1. roe coaly of -Batt. 1. par Oetpt•f a this Is-
�/ ere roma
W1111mn �f RC.E /47'26 Rp, E1m, 3/71/.37
Coag Swveyer - County of Salt.
RECORDER'S STATEMENT
Find We Z NO. day o/ -1-MLY , 19 ?-A
at p'o/ .4_AL I" Srot 129 e/ Poml Map, 01 pop. 81-R
of the request of LeL SURVEYING ,
Soviet No. 9 3-2 j4&'
OWNER'S STATEMENT AND ADDITIONAL INFORMATION SHEET
Am OwneA Sfatepen/ else Ad1117.nd Infamwuitso shhe•/Ip fel .flu hq
fill. hol
R -der of ado. Case
ander Recorder". 6er/at hie 473-Z>9r2v end mMr R.... 'Y
$.Ilei Ah p..p.art..y.
A.P NO. 51-031-004 PTR
PARCEL MAP
,OF PHASE II FOR
ATTILA KASZA ET AL
Being a portion of theS.W.1/4 of
Section 31 -T.22 N. R.4 E.-M.DRek
SEPTEMBER, 1991
Butle County, Colifornia
1
FD. " O.I.P. AS L A L SURVEYING
FD. I COR PER W
1007 BIL e c ROAD 4 PARADISE, CALIFORNIA 968600871
(816)8774687'/ (81 W 877.1300
Job 14x0043-097
APPROX. CS /
V\ Ky.ILE
Z.. 1 PARCEL 2 APPROII HIC44WA R
NET USABLE LINE
\ 71297292 $f. IDT• SEPTIC - P
• FFRROM WGNINE
I -
WATER LINE '
AT CREEK
BUILDING f I I
SETBACK LINE FFFOddd tll�tlll
_ uuu��� ND
1OR
C < a OLS
PARCEL 3' I$ N �PARCUS-A.Y 11
OEEW NERD A"
AVOID BARRIER
SE
MET U UNE "TARN GRATIOM'
Sulol"NET USABLE
_267891.72 �� _
I \
200' LEACH FIELD
SETBACK LINE OF
RESERVOIR
2 KUNKLE
R£SV R
ARREEA OF EXPOS
LAVAJDT!
SUITABLE FDR
LEACHING FIELD
NET USABLE
48438239 S.F.
• r< a r. <) �
9 y L
tl IN y
q.!
Ty n y�
KV A s
F�
SHEETS 2 OF 2 SHEETS
�. oZ �i.�vt.oc�C'.:' �P` 93- ��'/�7 C'a.Y� � L'e->rrlo-�l4�•.: � i !% /9os/S
NOTES
I. ALL LOTS TO PAT ANY APPLICABLE OUR NERD MITIGATION FEET
IE
AT TTUE OF NILDIID POUT APPLICATION
2 OEVD,OPE'1ljR OP PARR28 b7 AND 4 WILL RIRE CONECTION
TO A PIIELK WI1TO1 q(VLT. EW
A NO GRAOURO, OILTIVATI0IL DISTIA7BANCE OF NATUUL VEGETATION
$CALK I'. 200' OR ��� OP IM@ROVENENTS SMALL OCCUR WITHIN 100'
OF THE BANK OF HOJNLE CREEK '
4. ALL RESIDENTIAL DEVELOPEMENT ON PARCEL 2 AND 3 SHALL OCCUR
WITHIN 330' OF THE CENTER LINE OF PENTZ ROAD.
UNSUITABLE AREA FOR INSTALLATION OF SEPTIC SYSTEMS
3. BUILDING SITES ON THESE PARCELS WILL NEED TO BE LOCATED
SO SEPTIC SYSTEMS CAN BE GRAVITY FED, AND INSTALED IN
USEABLE AREA.
4 AUTOMATIC FIRE SUPPRESSION GPRU*am 6YETEMIS SMALL BE '
6/BTALJ.ED IN ALL NEW RESIDEINTIAL
STRUCTURES IN ACCORDANCE
WRH THE .-.r—AL M PROTECTION ASSN STANDARD FOt THE
ALLATION OF INILER SYSTEMS IN OE AID TWO
FAMILY DWELLINGS AND MOBRE IDMES, WPA STANDARD 130. '
THE PURPOSE OF TIE' INSTALLATION Oi SPRINIOER SYSTEMS IS FOR -
ADDITIONAL SAFETY AND PROPERTY PNOTEGTiON N THE EVENT
OF RESIDENTIAL FIRER THOS INSTALLATION WNL REDUCE TIE
DEMAND FOR STRUCTURAL FIRE PROTECTION SOWICEE IN
THOSE INSTANCES INHERE THEY ARE INSTALLED.
T. NO FENCING ON BARRIER OF ANY KIND SMALL BE CONSTRUCTED
OR ERECTEDALONG THE EASTERN BOUNDARY OF PARCELS 293
IN ORDFJI TO ALLOW DEER HERD ACCESS TO WATER AND
AVOID: BARRIERS TO DEER IEID MIGRATIOHK.
B. UPON COMPLETION OF TIE CONSTRUCTION OF STARLIGHT LAZE,
TIE OWNERS OF RECORD SMALL REMEA ROAD MAINTAKANCE
AGREEMENT WITH THE COUNTY OF BUTTE
ADDITIONAL INFORMATION SHEET
PARCEL MAP
OF PHASE II FOR
ATTILA KASZA ET AL
BEING A PORTION OF THE S.W. 1/4 OF
SECTION 31 T.22 K R 4 E. MDM
BUTTE COUNTY, CALIFORNIA
SEPTEMBER. 1991
L a L MVEYING.
1007 BILLE RD. PARADISE, CALIFORNIA, 95968
70-Ob08T. ' _
SITE PLAN REVIEW APPLICATION
Date: l 'a2 & — d �) AP# _� �� 310 —0/ 7
Permit Number (if applicable)
Bin Number
APPLICANT INFORMATION �^ Parcel Size:
r)uma'%jQ re T�Tama• �`�" / � � G 6 n-4T—
Owners Address
-Telephone No.:
Situs Address:
Email:
Non-residential
❑ New Commercial
. ❑ Commercial Addition ❑ Commercial Remodel
❑ New Industrial
❑ Industrial Addition ❑ Industrial Remodel
Qther
Septic
❑ Agricultural Exempt Building
❑ Other:
❑ Well
❑ Agricultural Buffer Form ❑ Applicable ❑ N/A
Brief Explanation (if necessary): �� tA 0(4-0(1
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SER VICES INFORMATION (For Staff Use)
CMA
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
I Site n Stamped proved
By Date
T--
Page 1 of 5
IF COU1VTy
Proposed
Use:
'JUL 2 8n
2 04
Res' ential
New
DEVELOPMENT
Single Family Residential
i SERVICES
❑ Single Family.Addition
❑ Single Family Remodel
❑
Mobile Home
❑
Residential Accessory
❑
Permanent Second Dwelling
❑
Temporary Mobile Home (Aunt Minnie)
❑
Temporary Travel Trailer
❑
Multi -family
Non-residential
❑ New Commercial
. ❑ Commercial Addition ❑ Commercial Remodel
❑ New Industrial
❑ Industrial Addition ❑ Industrial Remodel
Qther
Septic
❑ Agricultural Exempt Building
❑ Other:
❑ Well
❑ Agricultural Buffer Form ❑ Applicable ❑ N/A
Brief Explanation (if necessary): �� tA 0(4-0(1
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SER VICES INFORMATION (For Staff Use)
CMA
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
I Site n Stamped proved
By Date
T--
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
Snow Load Area: i'S0-0 — 2e,001
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required)
a SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
• Flood Zone: X
• Flood Panel No.: 66e--iz-7 Ccs � 7S -C Index Date: ro — ` (`( `l•�
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
❑ Oroville Enterprise Zone
Use Requires:
❑ Use Permit ❑ Minor Use Permit
❑ Administrative Permit
❑ Minor Variance ❑ Variance
--------------------------------------------- —----- --------------------------------------------------------------------------------
❑ Detached Building Use Form ❑ Encroachment Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning:
Applicable Building Setbacks:
rl.opcp lM1.1 .l -.C-
Front
ZoningCode
/ij `
Streets & Highways
- �. uw
Fire Prevention
I Subdivision Map
Side
Side Street
Rear
�t
7 so,
�I
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. - ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development Fees:
Standard• Fees
❑ Fire
❑ 'School*
❑ Parks/Recreation -
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Drainage Area
❑ Thermalito Urban Area
❑ Other '
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
r
Amount Formula
Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By,
n Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes .
Comments: '
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation
❑ Obtain a Certificate of Compliance/Notice of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Page 3 of 5
10 Subdivision Map/Parcel Map:
Map Date of Recording:
Lot:
❑ Use Permit/Minor Use Permit
Permit Number:
-rsAA oq-o`
=
Date of Approval:
Page:
Parcel Map/Subdivision Map/Use Permit Conditions
❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for road maintenance, and stop sign maintenance.
C
Page 4of5
FT
' Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
C:\Lanys\Building Permit Site Plan Reviewl.doc
�-as-off.
Page 5 of 5
BUTTE COUNTY PUBLIC HEALTH DEPARTMENT
Division of EnvironmVhMk
P. 0. BOX 5364 AL HE/LTH 7 County Center Drive
411 Main Street eurrE° Oroville, CA- 95965
Chico, CA 95928JU .2 6 2004 (530) 538-7281
(530) 891-2727' ° FAX (530) 538-7785
FAX (530) 895-6512 °CouN<i�
APPLICATION FOR PERMIT TO CONSTRUCT AWA1b96SAL SYSTEM
Owner's Name A_7Assessor's Parcel No. DC'S 7�a Oda
Applicant's Name C�g r T Phone No. '677- 3 D Y'Z
Mailing Address 'G-7 $ 0
1. Construction Site
(street ancl num er or Irec Ion an distance to nearest crossroad)
2. Lot Size C'% D,41 ,9 feet x feet Acres
3. APPLICATION FOR:
New system for new building ❑ Auxiliary or secondary system
Repair of or addition to old system ❑ New system to replace existing facilities
4. Type of building to be served by proposed system:
❑ Mobile Home (size ) No. Bedrooms Garbage Disposal?
House No. Bedrooms 3 Garbagp Disposal? c'
Other (Specify) 6422AF To 94,
5. Water supply for premises: (Must be safe, potable water) Community Private Well ❑ Other
Water supply for adjoining properties: Community Private Well ❑ Other
6. WORKER'S COMPENSATION INSURANCE
I am aware of theprovisions of Section 3700 of the California Labor Code, which requires every employer to be insured
against liability for Worker's Compensation.
❑ I have placed on file with the County of Butte a Certification of Worker's Compensation Insurance.
certify that in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to be subject to the Worker's Compensation Laws of California.
7. SITE PLAN TO BE FURNISHED - Draw to scale on site plan the following:
a. Property lines. e. Show direction and approximate amount of slope.
b. Location of all proposed and existing buildings, f. Source of water.
Structures, driveways and parking area. g. Water lines.
c. Location of large trees, rocks, or other obstacles. h. Set back lines and easement.
d. Location of any well, spring, creek or other body I. Proposed sewage disposal system and area for
of water on the, parcel and within 100 feet of property line. replacement.
I hereby state that the information above or attached hereto is correct and true to the best of my knowledge. I
understand that the permit must be obtained before any construction is begun either on the building or on the sewage
disposal system, and that a satisfactory inspection of the system is required before the new building or dwelling. may be
occupied or the s stem backfilled, or put Into use. I also understand that a safe potable water must be supplied to the
new building or elling befo —nccy-'can take place.
Signed < < Owner ❑ Authorized Agent ❑ Licensed Contractor ❑
Date `f UJ (An original letter of authorization must accompany this application
In order for an authorized agent to sign).
FOR OFFICE USE ONLY
Legal parcel? Zoning Use rm't ? A c s
Water plans cleared Potable water Receipt No. _Amount
Comment
App/SewDi sposal Sys/11 /2003
BUTTE COUNTY
ENW RONMENTAL. HEALTH
JUL 2 ,6 2004
CHICO, CALIFORNIA.
AGRICULTURAL BUFFER NOTIFICATION AND/OR
UNUSUAL CIRCUMSTANCES REQUEST
Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This
dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify
unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not
available for lots being created, divided or subdivided.
Owner or Authorized Agent must complete the following and return with the required site plan to:
Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601
Name:
Phone: S 7-7-2o `i2
Mailing Address: S 7
E -Mail address
Assessor's Parcel Number., 3/0 C _
Reason you believe you qualify for the unusual circumstances exception:
A
or
7
Date
An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement
(well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone.
SITE PLAN REQUIREMENT: submit 4 copies with this form
Refer to the Site Pian Submittal handout for specific requirements
.....................................
Internal Dept Contact Info: ................................
..............................................................................
13 Env. Health ❑ Planning ❑ Building ❑ Other
Contact Person: Phone:
FORWARD THIS FORM To LARRY IN DEVELOPMENT SERVICES FOR PROCESSING
............................................................................
............................................................
For Agricultural Commissioner office use onl ...........................••.•
y. (to be completed after submittal)
_DISCRETIONARY PE WITS (Planning) MINISTERIAL PERMITS (Building)
❑ Exception Recommended ❑ Exception Granted with the
❑ Exception NOT Recommended following conditions:
Reason/Conditions/Specific setbacks from adjacent agricultural operations:
Agricultural Department Signature:
Date:
YMC 7/1/03
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