HomeMy WebLinkAbout064-180-020'BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
w (One Form per Building)"*`k^ ,,4-,�Q_
A. P., Number 6!•/-/u _ 2: Building Building Department No.
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Sc't ool District t� n n .-J ux City County Ea --jurisdiction
h Property Owner
Project Location/Address / �.f 7_, P r h r►
Subdivision Lot Number
Residential Development:
Sq. Footage/ 6 1-3
# of Living MHI Addition (Group R)
Units
i
Commercial/Industrial: a a Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Department Representative Date
(Floor Plans reviewed by School District Personnel)
Distr/Ct/Id No.
14,000 �/ n i School District certifies that
(Applicant Name) .y
(Street Address)
;7 (-ity)' (State) (Zip Co e)
has complied with the requirements of Resolution No. �.
by/,`E`he payment of. $ 5y representing'square `feet.
S-dK6-bI District Representative _T"DatT-
PAID BY CHECK NO. REMARKS:
BANK NO
PAID BY CASH
white -applicant, yellow -building department, pink -school -district
SCHOOL.FEE (8/88)