HomeMy WebLinkAbout064-180-026'. �i ". -
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Formt. perco Building)
A.P. Number Building Department No'.
School District A city county Jurisdiction
AA I I I . . .
Property Owner Lonna X/0 Ir- tl
/ 17J I- AJ, � t/
Project Location/Address
y V
..Subdivision Lot Number -
Residential Development: Sq. Footage . _lNq
# of Living MHI Addition (Grou� 9)
Units
.'Commercial/Industrial:
New
Sq. Footage
Addition (Including Exterior
Roofed Areas)
Date
District Id No.*
School District certifies that
ALL (:Z�v b&74W- �gL
(Applicant Name) (Phone umber)
0-11-ANAdO J
(Street Addrels) r a5ucst
(Cilty) (State) (Zip Code)
has complied with the requirements of Resolution No.
by the payment of $ representing /4 —square feet.
fi
( ila�
S000l District Ite—presentative
PAID BY CHECK NO.
BANK NO_
REMARKS:'
T
PAID%Y CASH
white -applicant, yellow -building department, pink -school district
SCHOOL.F — .(5/88)
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