HomeMy WebLinkAbout069-180-0550OW1141
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School District L
A.P. Number O
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form 04r Bulldigj)
L
Building Department No.
Property Owner
Property Location/Address 005 kl) /
Subdivision
Residential Development
No of Living Mobile Home
Units Installation
4 G ""Z
t Representative `
= City ®County
Lot No.
..................................................................................................................
Sq. Footage
INA
Addition/ *Supplemental to (Group R)
Conversion Permit #
'(No foundation inspection):
Hans reviewed by School District
District Identification No. /► Sg3
School District certifies that
Sq. Footage
(Including Exterior
oofed Areas)
Date
-? S- /�� cam_ _ 4X
(Street Address)
(Phone Number)
(City) ! (State) (Zip Code)
has complied with the requirements of Resolution No. / — d — /(j by payment of $
representing / 0 O D square feet.
School District Representative
Paid by Check #
Remarks:
AB 2926 $
FULL MITIGATION $
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 660201x), 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) feeformAs (10/98)dmm