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BUTTE COUNTY -SCHOOLS DEVELOPMENT FEE'CERTIFICATION FORM .
(One Form -per Building)
Building Department No.
�School'-District(,c 5 ?� City Q County Jurisdiction;
Property Owner Wya g
U '
Project Location/Address
Subdivision
Residential Development:
t
# of Living MHI.
Units
Lot Number
F7Sq. Footage 50
Addition ( roup R).
Commercial/Industrial:Sq. Footage
New Addition'(Including Exterior
# Roofed Areas)
r
`�.. Building Department Representative Date 4.
{ Ny
Dist!c d No. -a��o J
School.District certifies that
Wran�,,Iey -anij Mnrin Znijrmn n w --
(Applicant Name) -(Phone Number)
521 Valley View Drive
(Street Address)
<s
Paradise CA r 95969
(City) (State) ..(Zip Code)
;has o l
ped with the requirements of Resolution No.
d y the (�,yment of $ 0�0203.o20 representing square feet.
School District Representative Date
PAID BY CHECK NO. REMARKS:*
i�
BANK NO
e
PAID BY CASH
white -applicant, yellow -building department, pink -school district
SCHOOL . FEE (5/88)
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