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HomeMy WebLinkAbout060-100-029ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356 Download Forms: www.buttecounty.net/publicworks/forms.html NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE --TPc,.it Phone (530) 538-7157 Ext. 2016 Number 167 rict APPLICATION I / WE. the undersigned, hercby apply to the County of Butte for an cricroachrricni pcn-nit to do the rollowing work under or ovcr tl1C County roads and highways. all in accordancc with CountX ordinanccs andF_4ggpral laws. (All information cxccpt sig attire must bc typed or legibly printcd.) 1. Applicanl*s Name: V= rawAmb . I Ia. Company Name: 2. Address: .2.5.90 South Fft Aves,-_,e OMM CA 95965 sewles 3. Phone: (M) 533-3114 4. Ass. ( &.�) �-cejN .0 gW:_ ( ) rL_� S. Location ofWork to be Done ord-vel%,-, de -e- 6. Applicant's 412 lde5l I 7. Date: OUC49NIR &CTOR"S INFORMATION 8. Contractor's Name ME F210"RIMAS tkugmL.60 u4u��_ 25qn,S0idh Fifth Avanija 9. Address OrOVD19, CA 95965 10. Phone: (530)533-3114 11. Fax: G-:3 3 -- 2-1 Zb 12. Contractor*s License Number. 2_J49X7) 13. Cenificate of insurance: Yes 9 No: 14. Contractor*s Signalu 14a. Date Signed: IS. Authorized Agent: TYPE OF WORK TO BE DONE 16. Please Check: Curb: 11 Gutter. 11 Sidewalk:E] 17. If Driveway List Type:, Z/ 18. Other Work - Describe: 19. Plans Attached: 0 Yes 11 No PERMIT GRANTED In comptiance with the above request, and subject to aU terms, conditions (including those on page 2 of this permit form) and special conditions written below, permission is hcrcbv aramed. 9 20. Conditions zet yw e le n e re -41 a e- e_uAer1-&1r,1_0 �ne 0 1;7 1 010 1,wJj11 a-106"' t4reeo7,g�lWeA ;2_-o.4e_ 0 Underground Service Alert (U.S.A.) must be notified two working days prior to any excavaiion. 800-227-2600 2 1. 19 All work shall conform to accompanying: Detail lid Plans 0 Special Conditions 0 22. Date Issued 23. Expiration Date: eIR 3 24. Surciv: 25. Date Paid: 4A -1/0 Y� 26. Amount Paid: 27. Paid Uv: 21. I;Z*��J��L Mike Crump, Director of Public Works By: For County 29. Final Inspection Date: 30. Inspected Bv: 0 Completed - OK 9 Completed -Not OK 0 Additional Comments Attached 00** 3 1. Comments: Note: If permits are faxed to any number besides (530) 538-4356, they can be aeiayea up to one weey.. Page I of 2 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.netkdds PERMIT NO. BP040899 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/02/2004 APN: 060-100-029-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 7355 MEADOW CREEK DR BMD Date: — Contractor. Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: DEMO CABIN (264 SQ. FT.) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MINTON DAVID R. & CHRISTINE I to its issuance, also requires the applicant for such permit to file a ERLANDSON signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 1440 LAZY TRAIL DRIVE, CHICO CA she is exempt therefrom and the basis for the alleged exemption. Any 95926-7734 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).): (530) 895-8897 (530) 228-8897 BCMINTON@AOL.COM 1, 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 offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: MINTON DAVID R. & CHRISTINE I such work himself or herself or through his or her own employees, ERLANDSON 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.). 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business 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 Law.). Contractor: Q I am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: El I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #: Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance Engineer: carrier and policy number are: Carrier. Total Square Ft: 0 S. F. Policy #: I certify that in the performance of the work for which this permit is Valuation: issued, I shall not employ any person in any manner so as to $0.00 become subject to the workers' compensation laws of California, Census Code: 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. qh_11�� eco e; 8 _Z� Date: AenWa+ ,eellulfd Applicaaa�nt:����� 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 hereby issued under e plicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Res�lutiogq to do work indicated bove or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: B Date: PERMIT EXPIRES ON: (Date) Address: - L3 1 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. 0 Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. 0 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 duly 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 official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection urposes.t—, IiNsv Print Name: Signature: Date: Awner El Contractor El Agent for Owner El Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP jqc)'? DATE: �2 kh APN: e::gOv ldc> - C-�')-Ci ZONING: LA OWNE 'S LAST NAME: MV'yAV':!>y--' OWNER'S FIRST NAME: PHONE: n�' gn -I STREET ADD SS:i �c FAX 974- 74J 7939 CITY, ZIP: `e�� � E-MAIL: SITE ADDRESS: CITY, ZIP: NEAREST CROSS STREET: v TRACTILOT P. APPLICANT NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL' LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: VA PHONE: STREEiADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL* DESCRIPTION OR SCOPE OF WORK: ® 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 fees will be required. 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. For office use only: Notes: Application Received by. 1 Amount Received: �S e BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO.--) 0�_ I Os 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. ASSESSOR PARCEL NO. o6c;' — ) lx:> — �*q ZONING OWNER IM 11 1 - Pr9E N OWNER'S ADDRESS hr C-1 ca c -A 9-s LOCATION OF BUILDING B M&Jwas C/ �ftz, USE OF BUILDING r&c� 46v SIZE OF STRUCTURE 30 1600SQ. —1 x FT. TYPE OF CONSTRUCTION: WOODFRAME__k__ STEEL— CONCRETE— OTHER (Specify) TYPE OF SIDING wc>,J ROOF COVERING _7705 CC> M 2 R TYPE co Vr r eltv, A) Vt-/ ESTIMATED COST OF CONSTRUCTION F I- *7 1,9 -IS " 010 75 C- 04 $ AG Buildings shall comply with the minimum front, side, and rear yard setback requiremefs-ollhb applicable County Ordinances as follows: SIDES FRONT REAR— AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. 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 mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated about, and the purposed use confirms 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 any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date Signature of Owner Permit Fee - $60.00 The above'described AG Building is exempt from a b ilding perot- a_f0'_P I YD I PTL I Pr RQrG 11n Receipt No. I Manager Building Division By Date White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 i/ PERMIT APPLICATION DATA SHEET OWNER: fiw�� 1 d ASSESSOR PARCEL NUMBER Proposed Building Use: 44, f,)r e-,-, r Counter Technician: Date: Items required in order te(apply for a peirmit. All boxes NWST be checked OR marked NA in order to apply. 0 1. -Plot plans, 3 or 4 sets, signedty the preparer of the plans. 0 2. Complete plans, 3 or 4 sets, signed by the Ireparer of the plans. 0 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 0 4. Engineered truss details and layouts in duplicate. No faxes! 0 5. Ene ' compliance design and supporting documentation in duplicate. rgy 0 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. 0 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By 0 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ 0 9. Plot plan and business license approval from the City of Biggs .................................... 0 10. Letter of intent for non-residential buildings .......................................... 0 11. Detached Accessory Building Form filled out by the owner ..................................... 0 12. Hazardous Material Form ............................................................................... 0 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the followinj items.) 0 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... 0 15. Statement of Intent for Non -heated and A/C Buildings ............................................. 0 16. Sanitation and plot plan approval from the Environmental Health Department in 0 17. City of Chico Plumbing permit ......................................................................... 0 18. California Department, of Forestry plan approval 0 paid. Sent by: . ...................... 0 19. Planning approval for (A) Use: B)Parking: _(C) Parcel Check: 0 20. Contact Land Development about 0 Improvements, 0 Drainage ............ 0 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). 0 22. Pre -Inspection for required ................ 0 23. Contractor's license information. (Number, Name Style, Classification) ...................... 0 24. Worker's Compensation Carrier and �olicy Number ........ 0 25. Owner -Builder Verification (0 Given to owner, 0 Mailed to owner) ..................... 0 26. Letter of Signature authorization .................................................................... 0 27. Recorded copy of Agricultural Acknowledgment Statement ......................... ....... 0 28. Manufactured home utility clearance ............................................................... 0 29. Existing violations and/or expired permits ....................... * * '' * ­­ ­ * ....... **---- 0 30. 0 Grant. Deed, 0 M.H. Title/Statement of Facts, 0 Letter from Legal Owner, 0 Check to H.C.D. 0 31. Other: When issued Telephone 46Z�- and hold for pickup. I have bee inform d -o the above items and requireme�ts for obtaining a building permit. Applicant: �& - Date: ic fo rmi r t m 1. Index permit application for the abovee--items numbered: 2. Additional items required Contractor, designer, owner, was advised cf the above data by 0 phone, 0 mail, 0 counter, by Contractor, designer, owner, was advised of the above data by .0 phone, 0 mail, 0 counter, by Plans reviewed by: Date: ',Plans approved by: Structural reviewed by: Date: Siructural approved by: Note transfer by: Date: Yellow Buildine Divirion Plan Check Letter -Date: Date: Date: - Date: N I SITE PLAN. REVIEW APPLICATION Date: AP# 100- 02_c)_ Permit Number (if applicable) Bin Number A& - . APPLICANT INFORMATION Parcel Size: Owners Name: -F-0 J\j F� t> C)Ar2_1STUJ6 C-2LANL��C)jj Owners Address: Liq -2-X -r(ZA i z— _M_ C)A (C 0 6A O� 159 a4 Telephone No.: 689-7 Situs Address: '� 2� S S_ h--� �L- A _J-_'�o W C_ Q ei 6 t,7, b 0:?_ V�Q 7-r6 �� p 'bo W S Proposed Use: Residential F� New Single'Family Residential El Single Family Addition F� Mobile Home F] Residential Accessory F-1 Permanent Second Dwelling F-1 Temporary Mobile Home (Aunt Minnie) F-1 Temporary Travel Trailer F1 Multi -family - Non -residential - F] New Commercial R Commercial Addition New Industrial El Industrial Addition Other F� Septic* J@ -Agricultural Exempt Building Fj Other: Single Family Remodel El Commercial Remodel n Industrial Remodel F� Well E] Agricultural Buffer Form E] Applicable F� N/A Brief Explanation (if necessary): EX)S-FjP,,)C, C-nelrsj 6,0 DO NOT WRITE BELOW THIS LINE DEVELOPMENTSER VICES INFORMATION (For Staff Use) Approved Conditionally Approved Resolve Problems Prior to Approval, 'S a -r r -S A C_ I El Site Plan Stamped Approved By Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO TBIE PROPERTY Parcel Is In: R SnowLoadArea: L40TTQ -F0 F-1 Land Conservation Act Minimum Acreage: Verify residence can be built per contract F-1 Nitrate Action Plan (See Envirom-nental Health for standards) F� Watershed Protection Overlay Zone (See attached standards and requirements) El Expansive Soils (Test for expansive soils and if verified proper foundation design required) M SRA - (CDF to determine specific requirements) El 100 -Year Flood Plain: (See attached) Flood Zone: X Flood Panel No.: C5 0> -) 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) F-1 North Chico Specific Plan (See Development Fees Section and attached standards and requirements) E] Chapman/Mulberry (See attached standards and requirements) F-1 Cohasset Area (See attached standards and requirements) Ej Grading Zone (See attached handout) Use Requires: F1 Use Permit El Minor Use Permit Administrative Permit F1 Minor Variance F� Variance --------------------------------------------------------------------------------------------------------------- r-1 Detached Building Use Form Fj Encroachment Permit E] Agricultural Worker Affidavit Ej Agricultural Acknowledgement Statement Zoning: U Applicable Building Setbacks: F� Setbacks drawn on site Plan. [:] CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Front C5, OYL Side Side Street Rear SO Height Waterway NIA N/A N/A F� Setbacks drawn on site Plan. [:] CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Applicable Development Fees: I Standard Fees F-1 Fire School* M Parks/Recreation M Roads [—] Sheriff F-1 Drainage F] NCSP/CSA 87 r-1 Chico Urban Area Road El Thermalito Drainage Area 0 Thermalito Urban Area M Other -------------------------------------- Subdivision Map Special Fees El Water Tender El Road Improvement EJ North Oroville Area F� Other (per map) 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 F� Deeds: Date of Creation: Legal Access Provided: El No El Yes Deed of Reference: Legal Access Requiried E] No El Yes Parcel Frontage on Public * ly Maintained Road: El No El Yes, Road Name: Complies with County Standards for Deed Creation:E] No n Yes Comments: El Parcel Deemed to be legal I El Verify Legal Parcel . El Verify Legal Access El Provide Deed of Creation F] Obtain a Certificate of Compliance Fj Obtain a Merger El Obtain a Lot Line Adjustment Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). El Construct road to: El Meet Parcel size required by zone El Meet current Environmental Health Department requirements Page 3 of 5 Subdivision Mgp/ParcelMgp: 4��,UTMS Map Date of Recording: 0? -1-7 2- I�p Lot: Book: Page: 0 Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map[Use Permit Conditions E] Comply with the following Conditions of Approval: F1 Attached Ej None F-1 Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 Fj 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. F-1 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. F-1 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. F1 In lieu of a priessurized 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. F] Class A roofs are required. Property owners responsible for road maintenance, and stop sign maintenance. 701 Page 4 of 5 it AR ZIS 35 A67U 7 M E,11 1yu1W404E.#R OUB-Dlylcrloly (a ^vo r or szwc;�-10,y z.9 - r za 1Y - -A? 4 i 11Y 041 r '0 CAL O/YO A* 00IN50-ly - C'A,'/,- 4r,,*,O�&Yz C"AMCO CIO—, hw Kj:0W A=' M �Y that tht BUTT19 COUNTY 3AV11;G3 1Wly., a 001� I do*e heredy certify it is the poratioo. by its duly authorized offiOsrs. used said lands ti) owner of.the lands dolinented hereon, that it has On Conveying be eufv4y*d and laid out In Lots for the Pu"/000 Of selling- D or a6ny 6ther pu ".E%e of deeiw�ation by reference to and Jr. accordanc* X 215, X with this map. BUTTS CUIP.:-,Y '-�P'1:!GS'13A1X President by cretary STAU Ci C11ii 1101U;1 A) j CoLM-jy uF BUTTZ 7 0.� his 2!!L"day 0 f 1926. A. D.. before mo4- i- t-1 14 a Notary puclic In and for a" . d County and State. duly comm�esiuned luid sworn, personally e4pneared OVY R. KM;ln= and T . J. BOHL1110. known to of to be respectively the Presidint and S*cretnry of the CorVoration. whosr. P.6 name ls�4ubscribed to the foregoing instrument. and acknowledged to 0 no that'-th4y orecuted the som� In behalf of the &aid Corporation. at my h3nd and affixed r37 IN V.ITHXSS rmmey I have hereunto a ofj*JcJ" saftl the day and year In this certificate &QOT* wr;L- ton. a Notary public in and county Of butte. state of Cal4f. E07 To. POYX LlgD RUBINSCCR. Civil Engineers,- do hereby Car- tify that we made the map shown hereon from our 0"'" -Ation of d V survoyi and that the map is o'corr4et dolin the lojide represented. Bach Lot Is designated cy-a Z05 number or letter. The zontimehts art of the chsrsctcr I and in the position shown on said map. A- PCIF, Ala) ROBIUSCM @ Va, A! E. M o rto n' and i, me County 0 Aseessor and County Surveyor. rospactly,ely of the County of Butte , State of. California do hereby car- tif that we have examined the lands In the subdi;i-1 sion shown hereon In the C*-.�Ay of Butte , and Vvii everymLot to suitable for rejnidfnce or cormeral.11 pur- OA comes. and we hereloy racomend the aoqevts�pco of this map. OA 0 % County Surveyor Coun Arhossor STATH '!;6F CALITOPITIA 9.6. S ij Couli-Ay 07 BUTTE 1. L vcy A.R so hards:,Audixor of the County,of ry fla . State of Caljfci��ja' do hereby Corti that there are no liene for,any County. Stat Othqri3A&xeq. except taxes ngt yel. payable. tc 01 any of' the lands of this a�oaivlr,ion in the County- ZA 0 f. of Butte 0) l.; -.:1rNFSS TnOWUV', I have hereunto set my hand and afllx;d my official Deal thi94 day of V, 1926 D. (D (rty Auditor Recurded in the Office of the County Rscordqr� 0 lof B��Jloj Co, State of Califc"rnia, this /7-Aday Uf A r. -f 1926 at �,in'uten past 14' 0 C, Olc: :k 4L, A-1 !710 01 County."Iecordor dfler ave co�s;.*,Wim. i3 anYelvd h6/ /heq�m Ae�-A�'is ho-hy4o,"kW ATTEST, and a'adarvd 16 he 1ho dffc4l &A p ef ourre 4rLdappv--, 3dB01r15tW /y, F 7 Tr %