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Home My WebLink About058-530-024Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www. b u tte c o u n tv. n etld d s www.butteaeneralplan.net FACMROC SEP 12 M6 RECEIVED APPLICATION FOR ADMINISTRATIVE PERMIT FOR SPECIAL TEMPORARY TRAVEL / TRgLER - 2008 BUTTE COUNTY FIRES* ,p Owner: 1 �(� %z'PS Phone #: CS_ Mailing Address: i Ox 1,J C E-mail Address: ISC%-, V-,-\ e—, 1 (1 O Phone #: Assessor's Parcel Number: OS -5 ' S 3d - O Z Street Address of Site: Q2� S � G 11 Y10LV, NaLl"_ 6� The temporary travel trailer is allowed for a maximum of 24 months from the date of the event; however, the use of the travel trailer will fall under the jurisdiction of Butte County Code Section 24-300(c) following the issuance of a building permit for a residential unit (stick -built or modular home). I [OWNER NAME] *Owners' Signature: correct. Date: t G * Temporary Travel Trailer permit specifically for those properties with residences impacted by the 2008 Butte County Fires. Residences not impacted by the 2008 Butte County Fires are eligible for a Temporary Travel Trailer pursuant to Butte County Code Section 24-300(c). Date revised: August 6, 2008 K:\BUILDING\Fire Storm 20081Forms\ DM_Special Temp Travel Trailer -08 BC Application.doc n c &b ,D 0- FAC/DR®C a J� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES AGRICULTURAL BUILDING EXEMPTION PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 0 YANA TR Owner: Permit No: B07-2334 APN: 058-530-024 BILLE BRESNAHAN Issued Date: 12/9/2008 By GLB Permit type: MISCELLANEOUS PO BOX 1584 Subtype: Ag Exempt CHICO, CA 95927 Expiration Date: 12/9/2009 Description: AG BUILDING FOR GOATS AND B (530) 230-8298 Occupancy: U-3 Zoning: FR10 1 Contractor Applicant: Square Footage: BILLE BRESNAHAN Building Garage Remdl/Addn PO BOX 1584 CHICO, CA 95927 Other Porch/Patio Total (530)230-8298 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $115.98 Total Charged: $191.68 Fees Paid: $191.68 Balance Due: $0.00 Receipt No: B5315 LICENSED CONTRACTOR'S DECLARATION OWNER/ BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 12/9/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date j I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE �� `J COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued, improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compansation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number: Exp. Date: (This section need not be competed if the permit is or one hundred dollars ($100) oror eT) ❑ 1 AM EXEMPT under Section B. 8 P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any man1R\so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 12/9/2008 compensation provisiops of Section 3700 of he Labor Code, I shall forthwith comply with those Owners Sign a Date pro isions 12/9/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TOS URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONEry, including death, and property damage caused arising out in any way connected with HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) the is t is is a ge that issuance of this permit does not authorize the the issuance of this p it. I hereRor DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or opjwpancy of a y sidewalksrbsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Co o enter the ve mentinspection purposesI hereby certify that I am the pr. rty o ora authori property owners behalf. 12/9/2008 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Pe ttee [ IGN] tint Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR; DAgent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net/dds AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials V 6 AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials �8 AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, _ 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initialsy� AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 0 YANA TR Permit No: B07-2334 APN: 058-530-024 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: U-3 Permit Subtype: Ag Exempt Zoning: FR10 00 Description: AG BUILDING FOR GOATS AND BEES Required Setbacks: Applicant: BILLE BRESNAHAN Front: Side: 20' Rear: 20' PO BOX 1584 Type of Construction: CHICOCA95927 (530) 230-8298 Type of Siding: T-111 Owner: BILLE BRESNAHAN Est. Const. Cost: S 7,000.00 PO BOX 1584 CHICO, CA 95927 Roof Covering: Compostion (530) 230-8298 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect At that time and pFor to occupancy. Signature of owner: FILE COPY Date: 11/15/2007 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION] OFFICE #: (530) 538-7541 FAX #: (530) 5 8-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.,net/dIdds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last N A,Df-- Lq l Mailing Addre O, s City City e ;\ State Zip C v Ph .Sb) �-3 0 _ Z.� Fax E-mail CONTRACTOR , Name Name Address City St Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ NGINEER Name �70 0 ` Address Stat City O t_ State Zip Phone Fax E mail State License Number APPLICANT INFORMATION NameI 1 k) S � Address F- Ot I U ( S tJ City ( r' � t- Stat zin S L O t_ Fax E-mail PERMIT NO. 50.033$ PROJECT LOCATION Property Addre s (-) J City on c'L:) Policy Number Carrier BIN # WORKER'S COMPENSATION If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address yy DESCRIPTION OR SCOPE OF WORK: bum- e Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office us y: Zoning Plood Zone I SRA Yes No Occ, I Type Const. a BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: YANA TR Owner: Permit NO: B07-2192 APN: 058-530-024 BILLIE BRESNAHAN Issued Date: 11/05/2007 By KCG Permit type: MISCELLANEOUS PO BOX 1584 Subtype: Electric Panel CHICO, CA 95927 Expiration Date: 11/04/2008 Description: ELECTRIC FOR WELL ONLY (530) 230-8928 Occupancy: Zoning: FR10 I Contractor Applicant: Square Footage: TO BE DETEMINED BILLIE BRESNAHAN Building Garage Remdl/Addn PO BOX 1584 CHICO, CA 95927 Other Porch/Patio Total (530)230-8928 FEE INFORMATION DBE Single Phase Service-Resid $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B5074 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License TO BE DETEMINED / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 11/05/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permitis or on�d dollars ($100) or less.) ❑IAM EXEMPT under Section B. & P.C. for this reason: r I CERTIFY THAT IN THE PERFORMANCE OF TH OR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any ma er so as become subject to the Workers' Compensation laws of California, and agree that' I should b come subject to the workers' 11/05/2007 CA mpensal' provisions of ction 3700 o e abor Code I shall forthwith comply with those Owners Signature Date p visio . - X11/05/2007 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TOS URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN MPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and prop_ mage caused arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) t is the issuance of is permit. I he y a owledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or= c of any side alk, sl et, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Co toe ova __tion property for inspection purposes. I hereby certify that I am the arty a aut rile act th opertvpwner _half. CONSTRUCTION LENDING AGENCY 1/05/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name o e mittee [SIGN] Pfl to the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. ElAgent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip Autte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION 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 permit. 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° 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. There may be financial risks to you if you do not cant' out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° 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 thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor 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's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BOLL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PILI TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. YES R NO) 2. le)/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE COT CTE WITH F LLOWING PEI2S0 (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRENAMEE�17krn 1 CITY PHONE CONTRACTORS 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: ADDRESS CITY PHONE CONTRACTORS 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 Description: ELECTRIC FOR WELL ONLY Reference Number: B07-2192 Applicant Name: BILLIE BRESNAHAN Owner's Name: BILLIEA _ AP # : 058-530-02 Signature of Property Owner Date: 1) t/ r` BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Na I Firsam B US f130 1W 4 Mailing Address 6 City State Zip 5 Phege o _g zCZ Fax E-mail CONTRACTOR Name Address City Address Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name iFlood Zone Address Statqr L City Phono Z� State Zip Phone Sq FT- Living Garage Fax E mail 5 State License Number APPLICANT INFORMATION Name ; l 0� S P1 Gk—k Address iFlood Zone City Statqr L Zil sl Z�) Phono Z� Fax E-mail /1 [WAWA J PROJECT LOCA TION AP# (3 S � — `0 3 6 -- 2,V Property Address � 0 City V� PERMIT NO. >'1_0?A BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's Cc must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Zoning T iFlood Zone SRA I Yes INo Occ. Type Const. Sq FT- Living Garage Open Cov ❑Structure Built without Permits [IProposed Change of Occupanc jNote previous use): 5 For office use only: Zoning T iFlood Zone SRA I Yes INo Occ. Type Const. LESS THAN 3 ACRE CONVERSION EXEMPTION STATE OF CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION NOTICE OF TIMBER OPERATIONS THAT ARE EXEMPT FROM CONVERSION AND TIMBER HARVESTING PLAN REQUIREMENTS RM -73(1104.1 a) (9/99) VALID FOR ONE YEAR FROM DATE OF RECEIPT BY CDF TIMBER OPERATIONS CANNOT START UNTIL VALID COPY OF A NOTICE OF ACCEPTANCE IS RECEIVED FROM CDF FOR ADMIN. USE ONLY Ex. # i i Date of Receipt Date Accepted Date Expires i 1 ► The Director of the Department of Forestry and Fire Protection is hereby notified of timber operations under the requirements of 14 CCR 1104.1(a). Harvesting of trees which is a single conversion to a non -timber growing use of timberland of less than three acres. (See 14 CCR 1104.1(a) for a description of the conditions on the conduct of this type of timber operation, and additional information that is required to be submitted.) Complete Items 1. through 8. on both pages of this notice. 1. TIMBER OWNER(S) OF RECORD: Name Gene JefferrV Rolls Address PO Box 432 City Forest Ranch State CA Zip 95942 Phone (530)343-7341 SIGNATURE Date TIMBER TAX EXEMPTION: Timber owners owe timber yield tax when they harvest trees unless the harvest is exempt (Revenue and Taxation Code sec. 38116) :Some small or low value harvests may be exempt from timber yield tax: Timber removed from an operation whose value does not exceed $3,b00 within a quarter, according to BOE Harvest Value Schedules, Rule 1024. If you believe your harvest may qualify for this exemption, please complete items A and B below. For timber yield tax information or for further assistance with these questions call the state Board of Equalization, 1-800-400-7115, or write: Timber Tax Section, MIC: 60, State Board of Equalization, P.O. Box 942879, Sacramento, California 94279-0060; or contact the BOE Web Page on the Internet at http://www.boe.ca.Lov. A. Circle the option that most closely estimates the total volume for this harvest, in thousands of board feet (mbf - Net Scribner short log):Under 8 mbf 8-15 mbf 16-25 mbf Over 25 mbf B. Estimate what percentage of timber to be removed during this harvest will be: Redwood _%; Ponderosa pine/Sugar_ %; Douglas -fir_%; Fir_%; Port -Orford Cedar—%; Cedar (IC, WRC)_ %; Other, conifer_ %; Other, hardwood—%. 2. TIMBERLAND OWNER(S) OF RECORD: Name Weston LVman Address PO Box 38 City Nice State CA Zip 95464 Phone (707)274-5605 1 certify, under penalty of perjury, that this is a one-time conversion to a non -timberland use, that there is a "bona fide intent" [14 CCR 1100 (b)] to convert to Yard and home construction site, and that I have mailed a letter of notice of intent to harvest timber, prepared by the Registered Professional Forester, to all adjacent landowners within 300 feet of the boundaries of the exemption. SIGNATURE Date 3. LICENSED TIMBER OPERATOR(S): Name Gene JefferrV Rolls Lic. No. A7332 Address PO Box 432 City Forest Ranch State CA Zip 95942 Phone (530)343-7341 SIGNATURE Date 1 4. Designate the legal land description of the location of timberland conversion. A map showing the location of the timberland i conversion MUST be attached. The map must show the ownership boundaries, the location of the timber operation, boundaries of the conversion, location and classification of all watercourses, and landing locations. Section Township Range Base & Meridian County Acreage to be Converted Assessors Parcel Number 11 22N 4E MDB&M BUTTE 1.25ac_ 058-530-024 Page 1. NOTE:This form has two pages. Continue on and complete Page 2. Read the instructions before attempting to complete 1 LESS THAN THREE ACRE CONVERSION EXEMPTION, Page 2. 5. The following are limitations or requirements for timber operations conducted under a Less Than Three Acre Conversion Exemption (Notice, Notice of Conversion Exemption, Conversion Exemption): A. Timber operations shall comply with all other applicable provisions of the Forest Practice Act and regulations, county general plans, zoning ordinances, and any implementing ordinances; copies of the state rules and regulations may be found on CDF's Web Page on the Internet at http://www.fire.ca.gov. B. All timber operations shall be complete within one year from the date of acceptance by the Director. C. All conversion activities shall be complete within two years from the date of acceptance by the Director unless under permit by local jurisdiction. Failure to complete the conversion requires compliance with stocking standards and stocking report requirements of the Act and board regulations. D. The timber operator shall remove or dispose of all slash or woody debris in accordance with 14 CCR 1104.1 (a) (2) (D). The timberland owner may assume responsibility for the slash treatment, provided the landowner acknowledges in writing to the Director such responsibility at the time of submission of this notice. The specific requirements shall be included with the acknowledgment. E. Timber operations shall not be conducted during the winter period unless a winter operation plan or in lieu practices required. by Forest Practice regulations are specified within (attached to) this Notice. F. No timber operations are allowed within a Watercourse and Lake Protection Zone unless specifically approved by local permit(e.g. county, city). G. No timber operations shall be conducted until the Director's notice of acceptance is received and a valid copy of this Notice and the Director's acceptance shall be kept on site during timber operations. H. No sites of rare, threatened or endangered plants or animals or species of special concern shall be disturbed, threatened, or damaged. I. No timber operations are allowed on significant historical or archeological sites. J. Within one month of the completion of timber operations, including slash disposal, the timberland owner shall submit a Work Completion Report to the Director. 6. I, %Q'/IiA >� LL`s declare as the authorized designee of the Butte County Board of Supervisors that this conversion exemption is in conformance with all county regulatory requirements, including public notice. (If the county has authorized a designee this item MUST be completed. If it has not, see item 7.) SIGNATURE Date -9 Los - 7. Registered Professional Forester preparing Notice: Name Randolph Vasquez Number 1884 Address 1600 Feather River Blvd Suite B City Oroville State CA Zip 95965 Phone (5301534-5229 I certify that 1, or my supervised designee: prepared this Notice of Conversion Exemption Timber Operations; visited the site and flagged the boundaries of the conversion exemption, applicable WLPZ's and equipment limitation zones; prepared a notice according to 14 CCR 1104.1(a)(3) to be mailed by the landowner and that a copy of the notice was posted and dated on the ownership, visible to the public, at least 5 days prior to the postmark date of submission of the Notice of Conversion Exemption, - and that if the County Board of Supervisors has not designated a representative authorized to sign in Item 6., that 1, or my supervised designee, contacted the county and the Notice is in conformance with county regulations. SIGNATURE of RPF Date 8. NOTICE SUBMITTER(S): Name Gene Jefferry Rolls Address PO Box 432 City Forest Ranch State CA Zip 95942 Phone (530)343-7341 Submitter must be either 1, 2, or 3 above, and must sign. SIGNATURE Date FILE THIS NOTICE WITH THE NEAREST CDF OFFICE BELOW FOR THE COUNTY IN WHICH THE OPERATION WILL OCCUR: Humboldt, Del Norte, Mendocino, Sonoma, Marin, Lake, Napa, Colusa, Solano, Alameda, 135 Ridgway Avenue San Mateo, Santa Cruz, Santa Clara, Contra Costa, and western Trinity Counties. _> Santa Rosa, CA 95401 Siskiyou, Modoc, Shasta, eastern Trinity, Lassen, Tehama, Glenn, Butte, Sutter, Plumas, => 6105 Airport Road Yuba, Sierra, Nevada, and Placer Counties. => Redding, CA 96002 EI Dorado, Amador, Alpine, Calaveras, Tuolumne, Mariposa, Merced, Madera, Fresno, Tulare, => 1234 East Shaw Avenue Kern, Stanislaus, San Benito, Monterey, King, San Joaquin and Sacramento Counties. => Fresno, CA 93710 Ventura, Los Angeles, San Bernadino, Orange, Riverside, Inyo, Mono, San Diego and => 2524 Mulberry Street Imperial Counties. => Riverside, CA 92501 WINTER OPERATIONS Lyman Conversion less than 3 acre conversion For Timber operations occurring within the Winter Season the following plan shall be used; The in -lieu option as allowed in 14 CCR 914 (934, 954) .7 14 CCR 934.7(c) 1) Tractor yarding, or the use of tractors for constructing layouts, firebreaks or other tractor roads shall be done only during dry, rainless periods where soils are not saturated. 2) Installation of drainage facilities and structures, is required from October 15 to May 1 on all constructed skid trails and tractor roads prior to sunset if the National Weather Service forecast is "chance" (30% or more) of rain within the next 24 hours The provisions of this subsection do not apply to mechanical site preparation. 3) During winter operations after rains, road use shall be suspended until the running surface has stabilized b freezing or drying. Hauling operations to cease when surface material must be shaped to develop a driveable medium. * No hauling, road construction, or maintenance shall occur when road surface is saturated as defined in CCR 895.1. Emergency road maintenance conducted to alleviate erosion problems does not fall under this limitation. * Erosion control structures will be maintained in working condition during wet weather road use at any time of the year. NOTE: "Winter period" means the period between November 15 and April 1, except as noted under special County Rules at Title 14 CCR 925.1, 926.18, 927.1, and 965.5 (a) except as otherwise provided in the rules: (1) All waterbreaks shall be installed no later than the beginning of the winte period of the current year of timber operations. (2) Installation of drainage facilities and structures is required from October 15 to November 15 and April 1 to May 1 on all constructed skid trails and tractor roads prior to sunset if the National Weather Service forecast is a "chance" (30% or more) c rain within the next 24 hours. R PORTION OF SECTION ll, T.22 N., RAE., E., M.D.B. a M. e .... - 36 3 la e 589°53'52"E 1318.73 ' 329.37 329.36 I ;220.00 220.00 220.00 i O ' � 2.0 'OOO so 8 ' Ac. '^ Ac. ac. 1329.37 329.36 O d d e ° b b ago$ O b b $ N o 3.34 3.34 3.34 i Ac0 n Ac� Ac. Ac Ac n 329.37 329.36 !220.001 220.00 1 220.00 330.00 330.00 p W inO e $ O O' /a 4/0 3 o �+� 2.50 n 2.50 2 50 2 50 ^ o ac. Ac Ac. °p 329.37 329.36 330: o Z /5 o x n 2.50 2. n 250 0 2 0 0 Center of W 1/4 Cor. ^ Ac. AC. �' i PM4�-411 Ac + Section l! S89°2!'56"E 1317.57 i i 329.37 329.36 330.00 330.00 S89°2156"E 1273.20 C.E. 1/16 Cor. Section 11 /96.74 8/6.7/ 304.12 I 023 510.00 763.20 Section l/ z -/.25Ac. op 22 c o 4/0.00/3 26 $ /4 24 / 2-- /9 329.37 a N /6 N /7 /„�+� 250 0 25 282 �� 8 2.17 O 29 0 AC. ^1 p Ac. 8 Ac. "� 3 0 v 329.37 �° 329.36 b 7 28 Ac. ' 8.59 Ac. ^ c b 'O l0.11 Ac. ,•� O I 4/0.00 249.64 0 b b 6.%Ac 20 b _ u e 36 b b 2/ h L25Ac. 1 2323 33 b p 2$ 3.00 "� O h'� $ �' 27 4.9' a '-E+/stMq 60' Rood Easement Ac. ; 250 d Ac. N _ _ __769.503 PM55-622 I Ac .2 G �. 3 m /96.74 .----5!/.42----------612.79---� �- 24 PM55-24 23,14' ---- n 329.37- 5t3 660.48---- --_5 '�4 589°32'/3"E_______________-_______- . _ x'1311.9 34 N Isn/ Tro// /979.68 - �- - --569°32'/4"E ^� 13.07 Ac. ' Z N PM53-964 �____-____/294.92-_______-___ k 28-Eliallnq 60' Rood Eaaemanl 03 j i r______ 589°37'41"E __-_-_-__-1 ° I 1 i . 58-53 Assessors Map No. 56-53 County of Butte, Colif. I nI� W SCALE, l"- 400 WINTER OPERATIONS Lyman Conversion. less than 3 acre conversion For Timber operations occurring within the Winter Season the following plan shall be used; The in -lieu option as allowed in 14 CCR 914 (934, 954) .7 14 CCR 934.7(c) 1) Tractor yarding, or the use of tractors for constructing layouts, firebreaks or other tractor roads shall be done only during dry, rainless periods where soils are not saturated. 2) Installation of drainage facilities and structures, is required from October 15 to May 1 on all constructed skid trails and tractor roads prior to sunset if the National Weather Service forecast is'p "chance" (30% or more) of rain within the next 24 hours The provisions of this subsection do not apply to mechanical site preparation. !f 3) During winter operations after rains, road use shall be suspended until the running surface has stabilized by freezing or drying. Hauling operations to cease when surface material must be shaped to develop a driveable medium. i * No hauling, road construction, or maintenance shall occur when road surface is saturated as defined in CCR 1 895.1. Emergency road maintenance conducted to alleviate erosion problems does not fall under this limitation: * Erosion control structures will be maintained in working condition during wet weather road use' at any time of the year. i NOTE: "Winter period" means the period between November 15 and April 1, except as noted under; special County Rules at Title 14 CCR 925.1, 926.18, 927.1, and 965.5 (a) except as otherwise provided in the rules: (1) All waterbreaks shall be installed no later than the beginning of the winter period of the current year of timber operations. (2) Installation of drainage facilities and structures is required from October 15 to November 15 and April 1 to May 1 on all constructed skid trails and tractor roads prior to sunset if the National Weather Service forecast is a "chance" (30% or more) of rain within the next 24 hours. I I i I 210 e, Jr. A 4., lrl-- 77 VA It 0 Zt ZL z: 5- -7 9ap *M- i -j It 2065b' A., Ile `rte,' EVCXO —7 T � cfain Memo k _4am N/ ol BY V .4 % t AI 16' E Name:PULGA Location: 039' 46'27.92" N 1210 30, 02.22" W Date: 7/19/2005 Caption: Lyman Conversion Scale: 1 inch equals 1000 feet Sec 11 T22N R4E MDBM Lyman Conversion Plat Map Butte County AP #58-53-24 - - T - 't, 1 SITE P�LAN �D� •��3 - - - - - - - _ - ••-•...--••-.... - --- ... .............- SE- vlu ._ - ... - r ------------------------- _...... __ :......C = =---•• .... `t J --•-............. --------------- .:- - --- - - -- - -- - .. -... ._ - - . ...... .. - - - -- -- --- - :.. = r -d- _... = .. ... .. •3 . . . . . . . . . . . . . . . . . . _, -- . . ......... .-. .. ... _... _. .. .. ._ .. ............................ ............. r : ...-•--- - ...... - o= �. -• . • -- . -- �... _.. J... .. .. .. ... .. . _ t 3 l: X ................... :......:.. . . - _...... -- : ......._.....'....._ ... _. . ... .. •• . r - - - - - = = - L ............. • ... ------ .: -2 • .I : j. -j -z-- -- - -- -- -P--.... ---- --esti -- - •- -- -- --- - - - -.......... • �. ...._ - ..-- . .. --...................r - ..... i e ►� .C.. 1 ......_............. ............. i : t : o o . :ro - ._..._.._._. ........................ .......... ......._/ ............ ------------- - .... -. .-------------.. ._ ............. ................... ................... ...................--- EVE ;. . . . . ... ............ . ... .............. ........ ........... ..................... ...... ............. ;... --- ::: . ...... .... .. ............. ...... . ........... ............. ..... ................. ... ......... ....... ....... ............. ------ --------- ............ ------ ------ ............. ....... ................ . ......................... ........... ................... .................. ............. ...... ...... ............ _....._..._..-. ........... ...... :. ...... t u �'� ( ri �,1 �_ 32 c( ��' Assessor's Parcel Number: to 0 �. ® � 0 Scale:C;�$Yps` gv T TFo Owner Name. - ..-__... - � l (` Address 1 Phone N P Oo x' I o.c� �I��c c) , C. 64 :: a Location n C� I - ontact: Carne - 1• f 1 r COU t, 'e S naho, Prone (S3 -a) a-- 8 2,� g 0ur_ ?,-3 Zoning: General Plan Desig: Size, Acres PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN. EASES: