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BUTTE COUNTY DEVELOPMENT FEE. CERTIFICATION FORM
D FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
D CHICO AREA RECREATION AND PARK DISTRICT (CARD)
APARADISE RECREATION AND PARK DISTRICT (PRPD)
D DURHAM RECREATION AND PARK DISTRICT (DRPD).
Assessor Parcel Number (s)
Property Owner (s)I[JI
Project Location /Address.
Subdivision Name
New Development
Alteration/Addition(s)
Mobile home
— Q qO — Q /Y—Building Permit Number O & -P/3'
Sq.'Ftge ;?_4 rd'
Type of Residential Development (check one)
Single Family -Detached Single Family -Attached
Non -Residential to Residential Multi -Family Dwelling
Mobile home replacement verified by Assessor Department
Demo Permit (date issued )
Comments:
Department
❑ D ❑ CARD J(]PRPD, ❑ DRPD certifies that:
plic Name
Mailing Address
Date
Phone Number
City
verified by Building Department
State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No
by Payment of.
Dwelling Units @ $ per unit for a total of $
p� �� Squarc Fcct @ $ e,
per s� foot for a total of $
Remarks:
Check No:� Paid by Cash:
R rrrratinn d Park District Representative
Receipt No:
Date
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School DistrictBuilding Department No.
A.P. Number otGip - O qU - o l7 . Jurisdiction: City County
Property Owner t � I lu,
Property Location/Address I � il7 -A ( (--f r t/ -,V— 0- a/,, • , / / ( lit "- 1 L-
Subdivision Lot No.
Residential Development Q
.......................................................................................
Q
Sq. Footage S a�
No of Living Mobile Home
Addition/
"Supplemental to
(Group. R)
Units Installation
Conversion
Permit #
:........................................................................................
*(No foundation inspection)
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial Q
New Addition
Building Department
District Identification No.AM
46,,d-'4 School District certifies that
FU �
� i' wJ i
if/
has complied with the requirements of Resolution No.
representing square feet.
School District Representative
Paid by Check # Remarks:
Cf4
(State)
Sq. Footage
(Including E=xterior
Roofed Areas)
Date I f
a,PA-, A4-ep4jb)
(Applicant) Ci
(Phone Number) \
(Zip Code)
by payment of $ _ , p^d
-- B 2926 S
ULL MITIGATION $
VA za(4
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 submk a timely written protest will prohibit
you from challenging the Imposition of the fees In any court action.
K, 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 On school district's schools.
White (school district), Yellow (building department), Pink (applicant) feef(M-As (3Po5Wnrn
t�
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District �� e�—� Building Department No. O —r
A.P. Number �tGto "Q Q� Jurisdiction: Q City E=rcounty
Property Owner
Property Location/Address
Subdivision Lot No.
Residential Development Q `Sq. Footage
No of Living Mobile Home Addition/ `Supplemental to (Group. R)
Units Installation Conversion Permit #
'• '(No foundation inspection)
........................................................................................
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial 0 0 Sq. Footage
New Addition (Including Exterior
Roofed Areas)
'D
Ouilding Department RepreW4tM Date
District Identification No./0
/1 _School District certifies that
(A licant)
(Street Address) a (Phone Number)
(City) a (State)
has complied with the requirements of Resolution � Jo.
representing square feet.
School District Representative
(Zip Code)
by payment of $ , pd
JFs 2926 $
FULL MITIGATION $
11y
Paid by Check #Remarks:��J�—� J
Aloffce : 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.
Iff, subsequent to the School District Representative signing this Buffo 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 Envlromnental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate Itis ImPect on the school district's schools.
White (school district), Yellow (building department), -Pink (applicant) feefonn.xis (3M5)dmm
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per. Building)
School District �� Building Department No.
A.P.-Number t�tgp —Q._O� Jurisdiction: City E=Tcounty
Property Owner
Property Location/Address
Subdivision
Residential Development Q
No of Living - Mobile Home
Units Installation
Commercial/Industrial Q
New Addition
ing Department
Lot No.
,..................................................................................... L I
Q Sq. Footage a T�
Addition/ 'Supplemental to (Group, R)
Conversion Permit #
*(No foundation inspection)
:........................................................................................
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Sq. Footage
(Including Exterior
Roof
0ed Areas)
�
Date
District Identification No. (�6 l rC K" )0 !7 rl fia Q
4LZ School District certifies that
-1 f l r (A licant)
X 9 0
(Street Address)
6
has complied with the requirements of Resolution No.
111t -i CSCF--V06q 0
is a...—o :�
04
(State)
representing 4�Tr-V— square feet. EL
26
�+ MIT
School District Representative
Paid by Check # �— Remarks:
(Zip Code)
by payment of $ (p(�'/,
S
Abdce: You may protest the Imposition of the fees IdenUNed 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 proles- 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 (CE®A),
.this project may be subject to additional school fees to fully mitigate Its Impact on the school district's schools.
White (school district), Yellow (building department), Pink (applicant) feeforn.xls (3/05)tmm
y�D"� LCA{' � t �}ytre ,� i tory ' . i • _ ,., ' -" r 7E-'fi '�..k�y�f�P� +'r'��i�K•�DF,���1-'"�'}�,�' +�JY �-�.�w:-:�:�
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
-' I
A. P. Number (Q �- Q / Building Department No.
School District /" City Q County [ Jurisdiction
Property Owner go u S�
Project Location/Address J3S%J
Subdivision Lot Number
Residential Development:
Sq. Footage
# of Living MHI Addition (Group R)
Units 7
Commercial/Industrial: Sq. Footage
New Addition (Includi-ng Exterior
Roofed Areas)
Building Department R presentative Date
D _tI d_
(Applicar
3c, 3 1
(Street 2
ty
ame)
=ess
i
School District certifies that
`�d13-
(Phone Number)
to
q 5 S s- 4
(Zip Code
has complied with the requirements of Resolution No.
bytheaym( nt of $ g(PS06 representing -/�b,� square feet.
School Distrizt Representative Date
PAID BY CHECK NO ,/ ?-'
BANK NO /70 — %dn 2
PAID BY CASH
REMARKS:
white -applicant, yellow -building department, pink -school district
SCHOOL . FEE (5/88)
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SCALE: APPROVED BY
DATE: Ap- n I
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