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058-730-031
'055=730"031 OG -0347 FERi\�ANDES, RAYMOND LITTLE BEND RD, OROVILLL- CONT: MERRELL & ASSOC NSF J: 'Al; COf);nCOL411fi 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. # Date of Date Accepted Date Expires 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 Jefferry 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 a operation whose value does not exceed $3,000 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 B Page on the Internet at http://N�wiv.boe.c.1Qov. OE Web 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 Raymond Fernandes Address 251 Wayne Charles Rd City Oroville State CA Zip 95966 Phone (530)370-9200 I 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 Site, and that / have mailed a letter of notice intent to harvest timber, prepared by the Registered Professional Forester, to all adjacent landowners within 1 feet of the boundaries of the exemption. SIGNATURE 3. LICENSED TIMBER OPERATOR(S): Name Gene Jefferry Rolls Lic. No. A7332 Address PO Box 432 City Forest Ranch State CA Zip 95942 Phone_(530)343-7341 SIGNATURE 4. Designate the legal land description of the location of timberland conversion. A Datemapshowing the location of the timberland conversion MUST be attached. The map must show the ownership boundaries, the location of the timber operation, boundaries the conversion, location and classification of all watercourses, and landing locations. Section Township Range Base & Meridian County . Acreage to be Converted Assessors Parcel Number 6 21 N 5E MDBBM BUTTE 1.20ac 058-730-031 Page 1. NOTE -.This form has two pages. Continue on and complete Page 2. Read the instructions before attempting to compli LESS THAN THREE ACRE CONVERSION EXEMPTION, Page 2. S. 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. I 6. I, ,declare as the authorized designee of Butte County that this I 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.) i SIGNATURE Date 7. Registered Professional Forester preparing Notice: Name Randolph Vasquez Number 1884 Address 1600 Feather River Blvd Suite B City Oroyille 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 954 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 Ave 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 Fernandes 058-730-031 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 by 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. •.ri,•xa.a- �.......a,.,,ee� ,yam lw+ '�». *+ r' Y + d t , r' r �' 'e•r• - 1 ,��_.,' �! 3 d�-••+"'--•_ . "t.me.i \ }.y�ib ,d? ��i,-;�^`"'''N�,�,� tr� tr`�tr_ I i + � + i � t!' 4' 'l�,ry,Y"'��YI �d ! Y 'S iiff ^x"_, .G •�. '� 1a1'k _ ."' P:.� i I +�'—•.�•r�.r:k-.,�•w.,T.q-r+,-.,a�.�.r;•w4..r�c-.......,:.,..�. y.«:v,,,,r�y^'sen!a...ltr'� .�a....«. ft a 't 1 ° 4 4 11i,joAs« z�, r• 'a �y k % �.r r ta"c.�•l. ' vi 'a.. r y :r . _ •�� 4+;;�v li ,,_. w ��_..�• ""•' ���' 114 ( I'l d {Y lir �°,tr•„c. ; ,` �g " _.r' _�r� - 3 ! '+��y �`1 dy�� R; •.rte._ "'a.re..-.,'-yce:.- .�. � Vg`s � �:,p' "w.'e�,, '� i�+ � sr} . W5 O -r /r ' f ! � 1. �!� �.,i - „ 3! '4,, •,,� 1 `` S Y `�_, �'� -.l k � .' w. .x.wr aw.e .{ .. 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', �t• - ♦ - �'� �_ rt�tr �•}tr,+ t%ld 1 �T ' .` � �r��' '1 l ft� �{ '� 4 y '`•� �`,,,.¢+. � }� 1T ' },'s _1 __'\ t fA (�y'F��i.fiIi'; I fi, dN�r r� 4. ' " r. kfi'�'.. �t `..,, `lt • '} i +... !'� SCALE 1:12000 Nil ? �, o i `'�, / - • 0 100 200 300 400 500 600 700 800 900 YARDS ff 0 1000 2000 FEET R Jd•r dJ --r •�r .� .NA. 0 100 200 300 400 500 600 700 800 METERS 16' E Name: BERRY CREEK t Location: 039'41'57.01"N 121-27'47.45"W Date: 4/3/2006 Caption: Fernandes Conversion Scale: 1 inch equals 1000 feet Sec 6 T21 N R5E MDBM Copyright iC) 1997, Maptech, Inc L T I G D I --L - i - /U20 S Fool 9E5/PfAcc- Fog RAY FGrepmNi ti r w o L�7TLF SENO Qd. 09001,6C-, CA �Prb r r L T I G D I --L - o - /U20 S Fool 9E5/PfAcc- Fog RAY FGrepmNi ti r w o L�7TLF SENO Qd. 09001,6C-, CA �Prb r Osg- 730-03! i� t ,- SITE PLAN REVf EW APPLICATION Date: ��3a/� AP# �cfi Permit Number (if applicable) Bin Number APPLICANT INFORMATIONParcel Size: Owners Name: i7- Owners Address:� 0 L' � Telephone No.: Site Address: Proposed Use: Cho 9� Goa --Ott C/ Residential ❑ New Single Family Residential ❑ 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 ❑ New Industrial ❑ Industrial Addition Other Septic Agricultural Exempt Building ❑ Other: ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form Brief Explanation/Issue: Zone: 1=�� GP: DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ❑ Resolved By Date Zov6 d 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 r-1 MinorUse Permit ❑ Minor Variance Zomig: F-4— ick General Plan: FA-?P— Applicable Bui-ilding Setbacks: ❑ Setbacks identified on site Plan. jj CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side LO 30' Side Street Rear Height Waterway N/A FF, N/A ❑ Setbacks identified on site Plan. jj CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 ij 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 Subdivision Map/Parcel Map: Map Date of Recording: QP,,; L tct i7 Lot: Book: %J Page: 3 (oo -g�•> BASIS OF BEARING: SURVEYOR'S CERTIFICATE f Th. South line of the S.W. Y, W Sec/ion 6 shown as This map was prepared ce with a under it direction end b based upon a 5 fi 1 Rare, W on S.H.fled .n Book /747 el Pagv 480, field survey in conformance with theVic requirements d the Subdivision Map OII%c%el Reeo,ds of utte County. Act al the request of Owen R. Vick on October 5, 1976. I hereby ` tocertify Yf1 conforms to the apped fenfefive map nd the conditions of i {{ thereof rov gGrr�, approval Thereof. ,' I) LEGEND n� �° �O Gp� Jo W. Hamby LS 2843 �\ O•Set hlon-n Pipe LS 2843 i 1 �• nd Abr,umenl as nofvd LOCATION MAP ••round -4'LR LS 2843 \ `7fr•Af / GF ,nllie • ��-- - COUNTY SURVEYOR'S CERTIFICATE .� Thu map=torms with the req jyta of ,hr 5ubdieision Map act end scat ordnance. Dale: l M.+r ,1977' _✓` STATE OF CALIFORNIA Suite County Surveyor GO:P�.v Gconfad to ter/oh G Ooofi March 19 /971, /7470. R. 480 COUNTY OF On .f!.`.r,, c/ , 197T before ma, the underai4ned, a Notary Public in and roe mk; Co my and stat,, peraoneay appeared Owen I R. Vick and Jewel r. Vick, known to me to be mRECORDERS CERTIFICATEe persons whose r�em¢I me a.b,.;b.d to the wimin instrument and acknowledged 'F%led thio _� day Of�s.L_ 19i�, of r.• a>r �'m. In Soo1}_Gn That they executed the same. of Parcel Maps at Page_E'r_ef the request of, 6O• Non Esduv+e Public Laaemeot for /• Serial No. 3t, ✓6 g ingress mdvgress and a,.b6e u1%lifies and ! :.I�:<%tea. ��••,. �!�12 ti.'._ //� - rt� to br rverrved in deeds. R �,.ds,.nawiGw�",.`ea.`i,N'iclw;_,auyno+2ulsW.twRtg ". h - nt � Peco,d er IYI 8127000 0521'28" al L• 93.69 ,� 1 I 1 R • 270.00 by L• 25.25 so0E (RPO• STATE OF CALIFORNIA Deputy so 1B H • 26 °_' COUNTY OF '� z 454.22 � E v, On'r%:Fo • A' 1977 before me, the underaigned,a Notary i ry1T 3g Public in and for said County and State, personaly appeared 4:59 : R - Elmer D. Smith and Hezvl J Smith, known to me to be the OWNERS' CERTIFICATE - - �'� W N persona nhosv names are wbscribed to the wilhln mstmment We John W. Hamby, Edith N. Hamby, Owen R. Vick, Jewell F Vick, a Lqq L. •., - - i and acknowledged that They eKa-led the same. 31,p5 - - - -•- �9 Elmer D. Smith and Hazel J. Smith as owners of the land as shown 3o.o7w PARCEL 3 \ yy��:,r;., �,_ /r%y�,,.�ti. hereon, do hereby certify that we are the only persons whose consent PARC Ac. - is necessary to pass title h3 said land and we hereby consent to the q, RA """, preparation and recordation of said map as shown within the colored ya• d ` ro MrlrylA A WARREN border lines. 01. _ .�4.e, sndlAN:ni4 cwlRY [t1 .�-..� .-r-� •. •PARCELI PARCEL 2 es. '^nen+nas.y," p �•E�•.u' �«�) ,�_a`—=4; n1.21 A,. — •.A.32 A,. xL •••tt%•••......EEE `�n�lf � 3 i 5TATE OF CALIFORNIA W P7o� COUNTY OF BUTTE •P � y 2 On f.-6 /9 ,19776efore me, fhv unders'gnay, a Nofery Publ, %n and 'f' CY h for said County end State, personally appeared John W. Hamby end Edith N. ••-.,si•A:"` 0 W br known to me to be /he persons whose nomas ere subscribed to the _ wifh;n m,l umerd and ednow)ydged that they es -ted the same. - z N- aAiTQ.:2Sa9A S, Ii 011' ` 11' - - 2- i�NI71.. SHiELOR 9 730.00 �aax rii+iu���w..•�`� P Sy' - 6S sse oz WW 265x.36 PARCEL MAP 58 4 5. Ya Cor. Per R.S. 3Sec G. FOR 3.W Ear.0—m. Sec. G /s5'/ran P: LS 2780 0►NEN R. VICK D.W.R. 54/58 /nl '3/38 Per Al 9758. A PORTION OF THE S.W 1/4 OF SECTION 6, T. 21 N.,RSE,MD.B.BM. BUTTE COUNTY CALIFORNIA SCALE: 1-•100' John W. Hamby By LS 2847 Licensed Land - Sarveyor Paradise Californio 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 HILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name � — t7v Firsl Name . FWD Address City �y4LLl�O StateG� Zip 6 Phone %O — Zoo Fax E-mail CONTRACTOR Name Address -P€g 0--, City C S State f. Zip `!tea y Phone Fax I E-mail I Lic. #�.9,7, I Classa, ff APPLICANT INFORMATI N ARCHITECT/ENGINEER J Name \ Address City State i Phone State Fax E-mail F State LicenseZVY ff APPLICANT INFORMATI N Nameb�2�So�cc�6 //06- /0GAddress Address I City Yes State Zip Phone E-mail F APPLICA T SIGNATURE Ix sk�4—_�J= For office use only: Zoning 1=2-I Flood Zone I SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner I Date Approved: nX/r:D Dnp cl iRnniTTAI RFnI IIRFMFMT.q PROJECT OCATION AP# 7_3 /C>3f Property Address G « �3�n oL City ��vr Cross Street ORKER'S COMPENSATION.... Policy u e ale VON ' anyone other than license contractors, a certificate of worker's o p nsation must be shown at the time of permit issuance. ff LENDING AGENCY Name Address Description or Scope of Work: Sq FT- Living Garage Zg p Open Covle8 ❑ Structure Built without Permits ❑ 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. 5 I% Received by: Amount: 7 Bldg %' SRA Receipt # Sheriff U� SMIP (� (� Dat Other ��I �� � Z — Total 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. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (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. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). 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 Commissioners office (if required). ❑ 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit 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 KAFORMSIBUILDING F0RMS1BIdQAoo1SubRamts.doc Paoe 2 of 2 RFV 8-12-05 03L/� 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: &-e>5-6-73o-07�,�++ Pl� ASSESSOR PARCEL NUMBER Proposed Building Use: N SIG Permit Technician: C �C=_!> Date: 2 - IV -0 6 Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. f N 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. tn, 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. IN 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. (A) 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including 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. must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildirigs, ❑ 12. Hazardous Material Form 10 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other 'Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) /�O ) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ( ❑� 16. Fire Sprinklers............................................................................................ �__O 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... �\ ❑ 19. Erosion Control Plan Required........................................................................ �] 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ _ 22. Site plan and business license approval from the City of Biggs .......................... 23. California Department of Forestry plan approval 0.paid7lSent by -�a_ ... .. (� �X- Planning approval for (A) Use: ✓ (B)Parking: (C) Parcel Check: ......... L� ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ ItA26. NPDES Form.....................................................................:....................... 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... �❑ 31. Letter of Signature authorization.................................................................... © 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... \❑ 34. Deed Restriction..........................................................:............................... O 35: ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... C!k 36. Other: / 1L*.nrT PJ C-L•Ya f2 -ems F 6F-' ew N Lt1,.,(� ❑ 37. Other: When issued Telephone t�/L/k-r j ?o -w- 26 sq and hold for pickup. All of these I have been informed of the above items and requirements for obtaining a building -per nit. Applicant: ��. ( Date: 1. Index permilappy ation for hbov items nu tiered: / Plan Check L iterd 1 C��Q ,oral items required C> ' , or, designer, owner, was advised of the above data by 2rphone, ❑mail, ❑counter, by YJ Date: yL.-� Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: I (g + Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: P Plans reviewed by: Date: lans approved by: Date: d Structural reviewed by: Date: Structural approved by: ' Date: e Note transfer by, Date: Yellow: Building Division BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner merrell and assoc. APN No: 058-730-031 Application Date 2/14/2006 Permit No: BP 060347 RECEIPT DATE Tech/Asst 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $2,217.77 1330.66 Plan Check portion of Permit Fee $887.11 �— 2 FEMA Flood Elevation Review $109.98 0 3 RYes SRA* Yes Fire Plan Check - Non -Refundable $95.00 (State Responsibility Area) Building Inspection $109.98 NON-REFUNDABLE portion of fees due at application FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $95.00 $109.98 $982.11 / ECmEcI,PT DATE Tech/Asst $1,092.09 ,�u3f6L 2_-I_I 4 SMTP* - Strong Motion Instrumentation Program (Enter amount from permit system)" T.60 5 Additional Plan Check Fees (NON-REFUNDABLE) C� 6 Other*: 6a Other*: FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT 7 IMPACT FEES - RESIDENTIAL* IPer Dwelling I Per Dwelling MH Applications After 2/14/05 ,> SFD ,c MFD ,> County 1 4096.87 3071.14 3117.43 Chico Urban Area 5372.09 3995.45 4889.56 EI Medio Fire District 3128.31 2297.77 2326.36 North Chico Specific Plan A SR -1, SR -3, SR-1/PD 7938.531 6757.081 R-1 8031.53 6850.08 ti° R-2 7541.531 6360.081 7633.49 7726.49 7236.49 R-3 6780.531 5599.081 6475.49 RECEIPT DATE Tech/Asst $4,196.87 Processing Fee is automatically added to impact fee total 1 $100.00 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# $200,00 8 DRAINAGE FEES* 9 CHICO STORM DRAINAGE 770 Butte Creek $7,736 MASTER PLAN 771 Comanche Creek $8,069 772 Little Chico Creek $8,792 New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 773 Big Chico Creek $6,596 RECEIPT DATE Tech/Asst 774 Lindo Channel $8,139 775 SUDAD Ditch $6,975 776 Mud -Sycamore Creek $6,070 777 PV Ditch $8,603 More than 1 acre, existing buildings - fees to be assessed by Public Works 9a Fee Determination Sheet Needed - Enter amount determined by PW THERMALITO DRAINAGE AREA $652 Maximum 10 Per each new living unit on existing lots where full drainage fees have not been paid Temporary Dwelling 1 $130 At time of building permit 10a $130 annual renewal fee for first 4 renewals. Not to exceed $652. PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO ISSUANCE OF PERMIT. Forms will be prepared after plan check is completed for applicant to take to respective district office. 11 SCHOOL DISTRICT FEES* Oroville High/Golden Feather 110 11a RECREATION DISTRICT FEES* rl paradise At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: Date: Pursuant to Govern a ode Section 66020, you are hereby notified those Items followed by an "*" may have been imposed on your project. You have 90 days from the date of approval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 1105 epaPublic Works rft-rlen t o f .0 o u n t y o f B U t•• t o `;: a= = ® J. Michael Crump, Director LAND DEVELOPMENT DNLSION .5 \ 6 Storm Water Management Pro -ram �0 aUN�7 Coun. Center Drive y p g Oroviile, CA 95 965 AUC (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Wafer Pollution Prevention Plan (SWPPP) Acknowledgement jLESS THAN I ACRE] Project Description: 5 I LO &C,G Project Location and/or Parcel Number: 7+;;W' 0,59 --7 -32 03� By sigaing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L therefore, do not need. to apply for a Construction Storm Water Permit fon 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. Title: wee-, 10 Date: 0Date: 2 f LI —QG Butte County Department ofDevelopment S'ervlces 7 County Center Drive °auTr�° Oroville, CA 95965 _.�� • ° (530) 538-7601 Telephone (530) 538-7785 Facsimile 00UN-� BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: I need to submit applications for septic and/or well to Butte County Environmental Health immediately. I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained e I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building_ permit or re wire submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but -are not .limited to, verification the parcel was legally created, adherence.to all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). ; Please print: Applicant Name: Building site address: C/%7ZC *-S-U p 1Zc� APN: 105-9 - 23C) —0"-Z,/ Permit No.: I have read, understood and accept the terms and. conditions as expressed herein as indicated by my submission of the above -referenced building permit aplication and my signature below: 2--1 `-ff c SF&11-IIURE OF APPLICANT DATE a Copy to Applicant/EH/File ICForms/BldePennitwithoutClearznces 020705 Cn ; seC. 6 PORT/ON SECT/ON 6, T2/N., R5E. 58-73 All Assessors' mops aro prepared for local property 58-72 assessment purposes ONLY and the poreds sham thereon may not comply with State and food svM1vlslonordlnances. No 1k6flity Is assumed for the use of the Infarmoft shown an any Assessors' map. 58-70 S 1/+ Cni Assessor's Map No. 58-73 County of Butte, Calif • (rip -gi BASIS OF BEARING: SURVE YORS. CERTIFICATE �`f 1 The South line of the S.W. V d Section 6 shown as 02'48'W on Geed fit9d m Book 1747 el P 480, This map ores prepared by�me.o. under my direction and is based upon a . a9' field surrey in conformance with the. requirements d the Subdivision Map, t Official Records of Butte County. Act at the request of Owen R. Vick on October 5, 1976.1 hereby LAND y,` certify 'that it conforms to theapproved tentativemap rid the condition}of approval thereof. r 1� G�20rr qEB ri , LEGEND J. w. Hamby L5 2845 O.5ef -V4'Iron Pipe L5 2843 JKC.S. 2843 �1 •• Found Monument as noted LOCATION MAP LS 2843 �4' LP. � ok p °F `Ali COUNTY SURVEYOR'S CERTIFICATE. .. This map conforms with The req.;— is d the Subdivision Map act and local ordinance. • Date: 7� °,'/ ,Iwr � 'fes Cou /�R�.l✓ Gionled/o ledoh G Ooo(?l a STATE OF CALIFORNIA � Butt.. nty Surveyor _ Ma ch 19 /971 /747 0 8, 480 COUNTY OF - _ On ,'Aa_rc,: 4 1977 belo.e mo the und—i,ncc, a Netory ` I Public in and for soli C—t and Slop t., n rwen ed OR. Vick and J -01F. Vick, known to me to be the peaeons whose RECORDERS CERTIFICATE names ere subscribed to the within instrument mut acknowledged Filed this 8' day oFOpkseL./9775, at 7: ,Z pm. in 1300 -f-0- fhaf they executed the some. d Percet Maps at Page�G7—al the request d 60• Non E.clueFe Public Easement fn � �1 Serial No. _?1_g •/6 t ingress andegress endp,blic Oihfiesa,d far !. r. /c,•,. r%/�vt�.. to be reserved in deeds._ �i IFu c WA¢¢(N /. baffe County Recorder 519'52'5?' 94, esrraw es/w. ps.w 1°11171 _ R• 270.00 tit 6.5' 21' 28- L• 93.69 I i R • 270.00 by L• 25.26Rp.Oi Deputy. so.00 07 STATE OF CALIFORNIA H7e•26 z COUNTY OF - r 1 39.E 454'22 N o On 11f4fW u 1977 before me, the undersigned,. Notary nQ ', Nlf' L Public to end forsmd County and State, pe--Iy appeared OWNERS' CERTIFICATE 0. Smith and H.z.1 J. Smith, known to me to be the �'� N, persona whose nemes are subscribed to the within inslr,manl We John W Hamby, Edith 31.03 --f°• a o-! 4.°r-"- i and acknowledged that they execufed the same. Elmer D. Smith and Hazel J. Smithb as ownVick, Vick, owners of and as shown 30.07PARCEL 3 �cc._ :�ms. %%1 v✓ hereon, do hereby certify that we are the only persons whose consent is necessary to pass title to said lend and we hereby mrisent to the y 4.33 A<. �D O �-•. m ;en preps tion and race dation of said map as shown within the colored '!`'-)rmwY�'��►.wM¢EH� border lines. sw+aw.�xsu ecosrry M PARCEL I m PARCEL 2 '9• r°�'A•tr^'�tiswr,sa.ron - �ps� '7. yir a n1.21 Ac. -------- 9.32 Ac. I / f , 77 J n in W STATE OF CALIFORNIA COUNTY OF BUTTE in ��t I OnEc,A 19 1977before me, the undersigned, a Notary Public inand for said County and Slate, personalty appeared John W. Hamby and Edith N. H Qf 0 Hamby known to me to be the pe,sons whose nemes are subscribed to the iv within imlrumant and ecknowl.dg•d that they .,-.led the some. 2 ul '[a ac>.lYXsfo�l: XiilllROi ' Orf'ICl ei. {i21 CORDON L SHt�L, D9 �s> mea o�.i+csti�i�o. 9 750.00 s 589.0248'w 265).36 - PARCEL MAP S W. Cor. Sar.6 f 5. A Cor. Sec. G. FOR D.W.R. Monument PS-1—Pfpa LS 2780 Per R.S. 53/58 Rs, 33/58 OWEN R. VICK _ - A PORTION OF THE S.W I/4 OF SECTION 6, T.21 N,R.SE,MO.UK BUTTE COUNTY CALIFORNIA SCALE: 1' • 100' By John W. Hamby . LS 2843 ` Licensee Land Surveyor . Paradise CaHforni. H-7991 - o& Department ®£ Public Works ° C o u n t y o f B u t t e O O 7 County Center Drive O Oroville, CA 95965 J. Michael'Crump, Director (530)538-7681 y (FAX) 538-7171 �eUc wo�`� Shawn H. O'Brien, Assistant Director Assessors Parcel Number: ,t 5 - =-73o -- r3i Building permit # OwnersName: Owners Mailing Address: ZSR, W tfi( 0 6- 5-7 Property Address: e-"--1 .%/ e- E SQ 2 3 (2 ^ G S-1 ENCROACHMENT PERMIT ACCEPTED: PERMIT NUMBER: ENCROACHMENT PERMIT EXEMPTION: Reason for exemption: -- • . Not a County maintained road L;-41 ❑ ' Existing driveway conforms to County S-3'1 standard ❑ Other Approved Printed Name �n % , 1-1K Title �Z g Date Z 0 CONDITIONS FOR EXEMPTING A DRIVEWAY PERMIT An existing home with a driveway 10 years or older and doesn't cause any problems with the county road or drainage. 2. An existing home with only minor remodeling or repairs. 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CENTER DRIVE ................................................................................................................................................................................................................................. ........................................................ ................... .................... .................... .................... .......................................... Assessor's Parcel Number < L Owner Name oyv�— Address'/ Phone No. 20 Site Location Contact: Name kaA4 I 91 ® - 12 M 41 - ® � FLI Scale: is@= 1/0 Phone S 34 370 Odebw 23,X03 . FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres 4.0(r .PROVIDE- FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: