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LESS AN 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 Receipt
Date Accepted
Date Expires
The Director ofthe 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($) OF RECORD: Name Daw Living Trust c/o Roy & Tamra West
Address PO Box 292
City Auburn 5,tate CA Zip 95604 Phone 530-367-3414
SIGNATURE Date
TIMBER TAX EXEM ners owWtimber yield tax when t ey arvest trees unless the harvest is exempt (Revenue and
Code sec. 38116) _Some small or low value harvests may be exempt from timber yield tax: Timber removed from an operation whose
does not exceed $3,000 within a quarter, according to BOE Harvest Value Schedules, Rule 1024. If you believe your harvest may qu,
this exemption, please complete items A and B below. For timber yield tax information or for further assistance with these que,
call the state Board of Equalization, 1-800-400-7115, or write: Timber Tax Section, MIC: 60, State Board of Equalization, P.O. Box
Sacramento, California 94279-0060; or contact the BOE Web Page on the Internet at http://www.boe.ca.gov.
A. Circle the option that most clo estimates the total volume for this harvest, in thousands of board feet (mbf - Net Sc
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/Suga�� %; Douglas -fir_%; Fir . %;
Port -Orford Cedar %; Cedar (IC, WRC)_ %; Other, conifer %; Other, hardwood %.
2. TIMBERLAND OWNER(S) OF RECORD; Name Daw Living Trust c/o Roy & Tamra West .
Address PO Box 292
J
for
City Auburn State CA Zip 95604 Phone 530-367-3414 i
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 driveway, house site, septic layout & parking area, and that I have mailed a letter of
notice of intent to harvest timber, prepared byloe Registered Professional Forester, to all adjacent landowners within 300
feet of the boundaries
3. LICENSED TIMBER OPERATOR(S): Name Dennis Elam Lic. No. A-1031
Address 6231 Custer Lane
City Oroville State CA Zip 95966 Phone 530-534-0896
SIGNATURE Date
No merchantable timber to be removed, brush and sub -merchantable conifer to be cleared and removed.
4. Designate the legal land description of the location of timberland conversion. A map showing the location of the timberland 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 -Number
35 21N 5E MDB&M Butte 0.65 L 062-350-0251
Page 1. NOTE: This form has two pages. Continue on and complete Page 2. Read the instructions before attempting to complete. i
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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 hftp:/Iwww.firb.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 acknowledgement.
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.
1. 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, (1&5 UJIO_ %'t C RA -1 g4r(neclare as the authorized designee of the County Board of Supervisors that
this conversion exemption is in conf mance with all county regulatory requirements, including public notice. (If the county has
authorized a designee is item T be completed. If it has not, see item 7.)
SIGNATURE Date�Ht71'�.�. 2�v7
7. Registered Professional orester preparing Notice: Name Greg P. Kostick Number 2194
Address PO Box 5939
City Oroville. State CA Zip 95966 Phone 530-533-0677
1 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 I, 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 Roy West
Address PO Box 292
City Auburn State CA Zip 95604 Phone 530-367-3414
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 Bemadino, Orange, Riverside, Inyo, Mono, San Diego and
=>
.2524 Mulberry Street
Imperial Counties.
=>
Riverside, CA 92501
Y•
77. •
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Daw Living Trust Exemption Map
Legend T21N-R5E-Section 35
Daw Living Trust Ownership............ Butte County
Existing permanent road .................. = Scale P= 325 feet
New permanent road........ ............... = = Berry Creek 7.5 min quad
Approximate House site location........ a Contour Interval 40 feet
Daw Living Trust Parcel/Ownership Map
Legend T21N-R5E-Section 35
Daw Living Trust Ownership............ Butte Count (Parcel Map 62-35)
Existing permanent road .................. G�Z7• Scale 1" = 124 feet %
New permanent. road ...................... = s
Approximate House site location........
4
Greg P Kostick
PO Box 5939
Oroville, CA 95966
530-533-0677
April 3, 2007
To Whom It May Concem:
An Exemption for a less than three acre conversion will be mailed to the California Department of Forestry and Fire
Protection, 6105 Airport Road, Redding, CA 96002, (530) 224-2445, on or after April 8, 2007 for the
Timber/Timberland owner listed below. The conversion is a one-time change of use from Timberland to
establishment for a house site, driveway, septic layout and parking area. Trees marked with blue paint will'be
harvested to provide space for these purposes.
A copy of this notice will be posted on the parcel at least five days prior to the mailing of the exemption to CDF. Each
property owner of record within 300 feet will be mailed a copy of this notice immediately prior to the exemption being
mailed to CDF.
The Butte County Planning Department is the county agency responsible for land uses changes. The phone number
for the Butte County Planning Office is 530-538-7601.
No watercourse are present within the conversion area.
No archeological sites have been identified.
The project area (0.65 acres) is Parcel #062-350-025 and is located in Section 35, T21 N, R5E, MDB&M.
Timberland and timber owners. are Daw Living Trust, c/o Roy & Tamra West, PO Box 292, Auburn, CA 95604.
Telephone Number: 530-367-3414.
The Licensed Timber Operator is: Dennis Elam, 6231 Custer Lane, Oroville, CA 95966.
Telephone Number: 530-534-0896 Licensed Timber Operator Number: 1031
Sincerely,
Greg P. Kostick
Registered Professional Forester #2194
Z/