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BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form 'per Building)
A.P. Number ��-�QG��%""D Building ,Department No.
SchoolDistrict. �(/fj,�i City n C-'ounty Jurisdiction
P,rope'rty .Ower
. Project Location/Address ..,/
Subdivision,' GQ(/�/7W q C Ly / Lot Number
'i Residential Development:
a a Sq. Footage/736o
# of Living MHI Addition (Group R)
Units
Commercial/Industrial: a Sq. Footage
New Addition (Including Exterior
Roofed Areas)
• /d 19D
Building epartme t Representative Datff
*******************************************************************
(Floor Plans reviewed by School District Personnel)
District Id No.
,
// (Applic� t
School District certifies that.
me) (Phone Number)
Street Address
y
9t.
State)
0
has compliedwith the requirements of Resolution No.
14 the pa ym fit of $ ��yo� d-�' representing square feet.
School District Representative Date
PAID BY CHECK NO.
BANK NO 4,! ., 0
PAID BY CASH
REMARKS:
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white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
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