HomeMy WebLinkAbout064-180-024V
BUTTE COUNTY SCHOOLS DEVSLOPME£NT FEE CERTIFICATION FORM
(One Form per Building)
A.P. Number 6 Building Department No.
� t
School District P(J roL 0(', Q City County Q Jurisdiction
Property Owner Ci r
Project Location/Address
Subdivision Lot Number
Residential Development:
Sq. Footage )S'317
# of Living MHI Addition (Group R)
o
Units
Y
Commercial/Industrial: D Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Depaf"tme`nt Representative Date
A
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.,(Floor Plans reviewed by School District Personnel)
District Id No.�—
94 School District certifies that
(Applicant•Name)• (Phone Number)
(Street Address)-
'D
(City) (State) (Zip Code)
has complied with the' req'uirementstof Resolution'No.
by -the -payment of $ r9n, representing J 3 square feet.
SIchool District Representative'-.,,.,,,,, `Date
PAID BYC ECR O REMARKS:
BANK NO /6 _3o
PAID BY'CASH
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) 4aiA==signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address . ` • Phone Type of Work
Signed:
Property Owne
Social Security ITiumber
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
•
I'
ALL STRUCTURES AND EQUIPMENT INCLUDff4G
OVERHANGS SHALL BE CLEAR OF ALL EASEMENTS.
,A SET BACK OF FT. FPCM THE SIDE AND
FT. FROM THE REAR PROPERTY LINES AND
„ FT. FROM THE ROAD CENTERLINE SHALL BE
CLEAR OF STRUCTURES AND EQUIPMENT E 0EM
tOR A 2 Ft. SAVE OVERHANG.
CARNEGIE
RD
-,— F. 0. C.
= 13'54'00"
= 331.00'
z
= 80.30'
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PROPOSED STAIRWAY/
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EX SEPTIC TANK ' is LEACH FIELD 1
-180-024 GOVNTY
IDW DEPAMM,
RO�'� '
ENVIRONMENTAL HEALTH
>=I Mt''v �' , AN uipmr4 f' INCW6 MAR 2 6 2003
SHALLBE OF ALL EASEMENTS:
A+ CET BACK OF FT. FROM THE SIDE AMC9, CALIFOR�,lp
FT. FS0,M THE REAPP �r '� M- -Y LINES AND'
FT. FFir..14 T >-1P. ROAD G IfC i s i Lli +w SHALL B>"
(XEA': OF S ; .i: 0TURES AND EQUIPMENT EXOEF'o
*?R X.: -F N:EAVEOVEIR ANG'.
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