HomeMy WebLinkAbout058-170-069SITE PLAN REVIEW APPLICATION
Date7 4 OV - AP# �5 � `c'-/-
Permit Number (if applicable) Bin Number
APPLICANT INFORMATION '7 Parcel Size:
Owners Name:
Owners Address: (/ - • L:� -C�
Telephone No.:
Site Address:
Proposed Use:
Residential
❑ New Single Family Residential
❑ Single Family Addition
❑ Single Family Remodel
❑ Mobile Home
❑ Residential Accessory
FI. 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:
Brief Explanation/Issue: ' a� '
q ��6 —
❑ _ Commercial Remodel
❑ Industrial Remodel
❑ Well
❑ Agricultural Buffer Form
r 10 ar) 1%
Zone: t(�
GP:
O
DEVELOPMENT SERVICES INFORMATION (For Staff Use
❑ Approved [Connditionally Approved El Resolve Problems Prior to Approval
❑ Resolved
By — � , .,� �� `�\, Date a _` 0 l^
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract
❑. Watershed Protection Overlay Zone
❑ SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain:
• Flood Zone:
• Flood Panel No.: Index Date:
❑ 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
❑ Chapman/Mulberry
❑, Cohasset Area
Use Requires:
❑
Use Permit
❑
Variance
❑
Agricultural Worker Affidavit
❑
Administrative Permit
❑
Minor Use Permit
❑
Minor Variance
Zoning:
Applicable Building Setbacks:
General Plan:
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
I
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
Side
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
I
Parcel Created By:
❑ . 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
❑ Obtain a Merger . ❑ Obtain a Lot Line Adjustment
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
W Subdivision Map/Parcel Map: DEAOMOO S 0 GO.
Map Date of Recording:
Z/ a� 87
Lot: j Book: / o b Page:
t
3
SITE PLAN
Assessor's Parcel Nu er: -191 ®— ❑ 0 ® — ❑ � M Scale: 1" _ . Q� / e 'TOO �rn Fe
Owner Name L 7 1P�
Address/ Phone No.
Site Location - Mu
Contact Name C P�d'. ` A Phone
Zoning:
General Plan Desig
Size, Acres
4.00`
PROVIDE FOR ALL
ADJACENT PARCELS
SIZE (AC):
ZONING:
GEN PLAN:
USES: - —
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