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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 l� 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 �-- /•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- O�c �0TTF / o �i, o o � o 0 d �0 C 0 ��� p 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 N` K \ yg366 \ 6 . 1fttlJ8'07'29E qN DETAIL "A" I 1 5 2648.997 ,1 \ I 2, .. 3 4 g1- 2649.61 1 s 4 , 1 N8e'0r7BE 9 B- A• 3'12'46" R• 2340 L• 142.4)07 101,1 P- M79 -3329E 0.33423' 91,}00' 280.0W 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 1m S 140.27 1----------�-'BUILDINGSETBACKLINE - - �Ilfff / I • ' it —�-{-------- i 1 Il t -i 20'133 i I 0 �\ gn CZ i i i t i � HI c: I! I cn m C3 =' H- 0 co I I ol. 1 W 0 — — BUILDING SETBACK LINE — �IN` -I nnV9N3aNI-1 140.01'