HomeMy WebLinkAbout065-330-065BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District 0 �� Building Department No. o6
A.P. Number' /
62 5- � �tP s Jurisdiction: City County
Property Owner —�
Property LocatiortAddress
Subdivision Lot No.
Residential Development Sq. Footage
No of Living Mobile Home Addition/ *Supplemental to (Group R)
Units Installation Conversion Permit #
'(No foundation inspection):
Comme7cial/Industrial rc^:tt EHi;+kms.'#' RE1 . h. . .
New Addition (Including Exterior
Roofed Areas)
Building Department Representative
runs reviewed by School District
1'1y/-.eQl:54School District certifies that
(State)
has complied with the requirements of Resolution No.
representing ��7,p square feet.
Representative
Paid by Check # "
Date
(Applicant)
%7A _-16 7k
(Phone Number)
(Zip Code) I
by payment of $
IFABiT2926 $
FULL MITIGATION $ W—b-3
Date
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. _
White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/98)dmm
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