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HomeMy WebLinkAbout069-180-017BUTTE COUNTY SCHOOLS1MPACT FEE CERTIFICATION FORM (06e Foim Per wilding) s t. School District ©L Building Department No. A. P. Number.Jurisdiction: City County Property Owner �_ A 8 9 y D U C 1 --os Property Location/Address CP, m G cl -,8 Lr G.% 0e90 Subd'ivison k ELLS/ %�.I �� E-6 / Lot No. S Residential Development [E Sq. Footage ` No. of Living MHI Addition (Group R) Units Commercial/Industrial r 0 New Addition (Floor Plans reviewed by School District Personnel) Sq. Footage (Including Exterior Roofed Areas) 3 --7 Date District Identification No. o �% School District certifies that (Applicant) �— Address) (State) (Phone Number) (Zip Code) has complied with the requirements of Resolution No. f� 9�-/t!9 by payment of $ representing As_�, square feet. School District Representative AB 2926 $ FULL MITIGATION $ Date Paid by Check # �% Remarks: Bank Number Paid by Cash 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 mitiaate its imaact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) teeformmk, (11/94)dmm