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HomeMy WebLinkAbout069-220-046AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 1.'007--00071 44 Recorded I REC EEE 7,00 Ufficial Records I County of I COPIES 2.00 ButteCMDAI UBBS Countty jerk-RJ. ecorderl I 011:ffM 12feb-M7 I Page I of I AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described.as follows: LOT 226, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES UNIT NO. 3", FILED IN THE OFFICE OF THE COUNTY RECORDER OF BUTTE COUNTY, CALIFORNIA, ON JULY 26,1974 IN BOOK 43 OF MAPS, AT PAGE(S) 44, 45, 46, 47 AND 48. AP NO. 069-220- 046 Date (9-7 PROPS TY OWNERS: p \rAMc, M . �oln Clue 22 _ li L 29i�14 t r � State of California ,V �h, County of go T- L- ) On 02 j 1 Coq t 2-06-7 before me, .Tnnet G , 1= t'(j►,e,Tavt sol v)�- . YJAo rel Pu bl Ir. A A personally appeare C1h r Ue,Z- 'PI r1a'M . MQ✓? pers ffM #Hewn -to- ne-(or proved to me on thW basis of satisfactory evi ence) to be the person whose na e(s) ' re subscribed to the within instrument and acknowledged to me that ludske/they executed the same in hi~their authorized capacity(ies), and that by hisAw/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand a d official seal. JANET G. FIORE TENNAM Commission # 1663858 Signature Seal:i@'MVCW==mAw4=1r9$Jun Notary Public - Cau fortNa 1.201 4 A.P. # T� L , j ' 3T NOR 13MAL 3 ylfwo:) attus nuL aeiIqx3.mmo:) V,,, mqpvw4pl4wmvpin 1 REQUEST -FOR CONNECTION - PERMIT APPLICATION FOR SEWER CONNECTION AND.SERVICE FROM LAKE..OROVILLE AREA PUBLIC UTILITY DISTRICT hereinafter referred to as ".Applicant:, . being the property owner or owbee.s agent.desinng sewer service, hereby requests Lake Oroville Area Public Utility District, hereinafter referred to.as "District", to connect Applicants sewage disposal line:to' District's sanitary sewer system and to provide sewerage service. r n /r 1 ^r�finn of nrnnprh/ I I l�% (I (1(�WI nA C�l� _ A.P.M.be 1— 0 22--�`� ❑ Property Annexed ❑ Property Not Annexed Property Annexation in Progress Kind of Service: 10 Residential ❑ Residence of Owner Connection Fee. ❑ Rental (single family) ❑ Rental (duplex) ❑ Apartment SC -OR Facility Charge: ❑ Industrial ❑ Commercial Total Amount Payable This Permit: Site plan reviewed 0 Jobsite reviewed Low.' ot# 2-2-& Block#: No. of E.D.U.'s this permit: Multiplication Factor:_ *Monthly Charges: Capacity Charge: The service applied for hereby shall be in accordance with the conditions hereinafter set forth and the ordinances, rules -,'regulations and policies. adopted, or:to be adopted,.by-the Board of Directors of District, all of which Applicant agrees to abide by and fully perform... Applicant agrees to pay for such service at'. rates and charges as are established by District from time to time. Signature of Applicat. Name of Owner if not Applicant 342-� CV\ D1 w1 , o ,4 Mailing Address of Applicant c. Ct Mailing Address of Owner Phone # of Applicant: � — 0 5 S U Phone .# of Owner: CONDITIONS OFACCEPTANCE.OF. SEWERAGE SERVICE 1. In accepting this application, District does not hold itself liable to Applicant for failure to perform any of the obligations imposed upon it or assumed by it under this application if such failure be caused by accident, Act of God, fire, -strikes, riots, war, lack of capacity in.SC-OR treatment/disposal plant or Districts lines to handle the sewage or nay other cause beyond reasonable control of District. 2. Installation of the. sewer service line pertinent to this application shall conform in all respects to District's specifications. - 4. Applicant shall secure. permits) .as. necessary from . the County of Butte prior to doing any work, including encroachment permits when work is within county right of way. 5. Installation of the subject sewer fine. shall be at the sole cost and expense of Applicant. 6. Actual connection of the subject.sewer service line to Districts sewer mainline shall be accomplished by District staff. 7. All work shall be inspected and approved by District 8. Subject tolhe.above conditions.a District Approval and Verification form may be issued as the District's permit. 9. This permit is valid for one (1) year. If work is not completed within said year, permit renewal will be required, together with payment of any increase in capacity fee, connection fee .and/or SC -OR Facility Charge. Payment of Fees/Char9es required prior to final LAKE OROVI R. P.U.D. inspection. Payment received by:. Date: Receipt # By J E]. CASH CHECK # CY7 2-- Date: 0/:S /( 'Permit #: *Monthly charge payable at the current -rate at time of connection. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 176 APACHE CIR Owner: Permit No: B06-2335 APN: 069-220-046 MARQUEZ, ROBERT & KRIST Issued Date: 02/12/2007 By KEJ Permit type: RESIDENTIAL 342 MISSION OLIVE RD Subtype: SFD-Custom/Model OROVILLE, CA 95966 Expiration Date: 02/12/2008 Description: NEW SINGLE FAMILY RESIDENC] (530) 589-0558 Occupancy: R-3 Zoning: RTI Contractor Applicant: Square Footage: MARQUEZ, ROBERT & KRIS Building Garage Remdl/Addn 342 MISSION OLIVE RD 1,749 484 OROVILLE, CA 95966 Other Porch/Patio Total (530) 589-0558 329 96 2,658 FEE INFORMATION County Impact - SFD $2,244.02 SMIP - Residential $0.50 DBSMIP Residential $12.51 Dwelling - Custom, Model $1,085.26 Dwelling - Custom, Model $1,627.90 Fire Ping Appl Fee (SRA) -Fire- $95.00 Impact Processing Auditor $50.00 Impact Processing DDS $50.00 Total Charged: $7,170.28 Fees Paid: $7,170.28 Res Impact Fees -SFD $2,005.09 Balance Due: $0.00 Receipt No: B332 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects of not more than five hundred dollars 02/12/2007 penalty [$500]; the following: &N, Contractors Signature Date F THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE , WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL the work himself or herself or through his or her own employees, provided that such improvements ❑I MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑❑ Section I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carni Policy Number: Exp. Date: (T ' section nee not be competed if the permit is or one hundred dollars ($100) or less. ❑ I AM EXEMPT under Se n B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not am Piany person in any manner so as to become subject to the Workers' %Compensation laws of Cal omia, and agree that if I should become s <act to the workers' X U2/12/200 compensation provisions o Section 3700 of the Labor Code, I sh orthwilh comply with those Owners Signature Date provisions. X 02/12/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Sign re Date WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, WARNING: FAILURE TO SECURE WORKELCOMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out oof, or in any way connected with o DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. AuseMorcupancany bove mentioned property for inspection purposes. I hereby certify that I am the authorized to act on the property owners behalf. CONSTRUCTION LENDING AGENCY 02/12/2007 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for me o mi ee [SI Pont Date the performance of the work for which this permit is issued. (3097 civ. code) caner ❑ Contractor OR;Agent for Owner ❑Agent for Contractor FILE COPY Lenders Address City State Zip Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B06-2335 Date: 09/29/2006 Location: 176 APACHE CIR By: TMP Parcel Number: 069-220-046 Sub Type: SFD-Custom/Model Owner Name: MAROUEZ, ROBERT & KRISTYN Phone: (530) 589-0558 Description: NEW SINGLE FAMILY RESIDENCE The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS ❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 a❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 ❑ ❑ City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS ❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 ❑ ❑ Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 ❑ Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 1:1 ❑ Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 SCHOOL DISTRICTS ❑ ❑ Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 ❑ Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 ❑ ❑ Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 ❑ Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 `-�+�V ❑ Orooville E_lenientary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Ell OrovilloeQUU ❑niioon High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 ❑ ❑ Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER �e�¢�o�dead�cBopy of Agricultural Acknowledgment Statement- See Attached Instructions ❑ ❑ City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 LI ❑ Other: jr)p;PC� ❑ ❑ Other: ❑ ❑ Other: Signature of Property Owner: ELVADate: 09/29/2006 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perforin their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY P TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. (YES)DR NO) 2. ((HAV�HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK, 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS - CITY PHONE CONTRACTORS LICENSE NO I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: NEW SINGLE FAMILY RESIDENCE Reference Number: B06-2335 0 Applicant Name: MARQUWf, ROBERT $F IdiISTYN Signature of Property Owner: BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 75965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B06-2335 Job Address: 176 APACHE CIR Contractor: DAVE ALVES 958 BIRD ST OROVILLE, CA 95965 Printed: 09/29/2006 11:52 am Fee Description Account Number Fee Amount Paid Date Pmt Amt County Impact - SFD SF - Public Works - Veh/Egp 1851-0-280-1011853 $658.17 SF - Public Works - Roads 1831-0-280-1011001 $1,244.88 SF - Public Works - Facility 1851-0-280-1011852 $340.97 Dwelling - Custom, Model N - Permit Fee 0010-440001-4210500-1010 $1,627.90 N - Plan Review Fee 0010-440001-4210500-1010 $1,085.26 09/29/2006 $1,085.26 Fire Ping Appl Fee (SRA) -Fire - 0100 -450001-4617240-1010 $95.00 09/29/2006 $95.00 Impact Processing Auditor 0010-050-4617998-101001 $50.00 Impact Processing DDS 0010-440001-4617999-1010 $50.00 Res Impact Fees - SFD SF - Gen Govt - Veh/Egp 1810-0-280-101001 $285.37 SF - Sheriff- Jail 1800-0-280-1011811 $288.00 SF - Library Vehicles 1825-0-280-1011828 $4.50 SF - Sheriff Facility 1840-0-280-1011841 $291.31 SF - Library Facility 1825-0-280-1011826 $224.20 SF - Sheriff Veh/Egp 1840-0-280-1011842 $142.14 SF - Gen Govt - Facility 1808-0-280-101001 $618.75 SF - Library Materials 1825-0-280-1011827 $150.82 SMIP - Residential Printed By: Tammie Powell 1001-0-280-1011298 $0.50 79157.77 $19180.26 Balance Due: $5,977.51 At the time of permit application, I was advised the above fees are required prior ro issuance of the permit. These fees may be changed during the plan checking process. Signature: L�Z� Date: 09/29/2006 Pursuant to Government code Section 66020, you are herby notified those items listed above may been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). Buttd County Department of Development Services fIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: • Make sure your application is complete. fry Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codesibutteco/ Reference Number: B06-2335 Date: 09/29/2006 Location: 176 APACHE CIR Parcel Number: 069-220-046 Owner Name: MARQUEZ, ROBERT & KRISTYN Phone: (530) 589-0558 Description: NEW SINGLE FAMILY RESIDENCE Signature of Property Owner: Date: 09/29/2006 FILE Butte County Department of Public Works T. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 75965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds National pollutant Disharche Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B06-2335 Location: 176 APACHE CIR Parcel Number: 069-220-046 Owner Name: MAROUEZ, ROBERT & KRISTYN Description: NEW SINGLE FAMILY RESIDENCE Date: 09/29/2006 By: TMP Sub Type: SFD-Custom/Model Phone: (530)589-0558 By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Title: FILE Date: 09/29/2006 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division of lndustrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY 1' TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT (YES R NO) 2. I (HA E/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CO CTED T THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME 7� ADDRESS ",TY_0(0 0ll PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJO RK: NAME ADDRESS CITY —0a"] � 0 PHONE S Sj -I� ,05z,� CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: Description: NEW SINGLE FAMILY RESIDENCE Reference Number: B06-2335 Applicant Name: MARQUE ROBERT & KIRISTYN Signature of Property Owner: Date: _6 6 '�0TrF0& department ®f Public ®rks > O 0 C o u n t y o f B u t t e 0 7 County Center Drive C OrovWe, CA 95965 o (530) 538-7681 00Utll J. Michael Crump, Director (FAX)538-7171 Crc WOR�S Shawn H. O'Brien, Assistant Director Assessors Parcel Number: �, —/)y Building permit #, Owners Name: Owners Mailing Address: 'S q' Property Address: iX 41:7.(L 6> i ENCROACI3MENT PERMIT ACCEPTED: PERMIT NUMBER: C ENCROACIIIVIENT PERMIT EXEMPTION: Reason for exemption: R Not a County maintained road F1 Existing driveway conforms to County S-31 standard Other Approved by r Printed Name �oc� i - ✓ '�n �� Title _ Q Date 7Z 3 ZO-4 CONDITIONS FOR EXEMPTING A DRIVEWAY PERMIT 1. An existing home with a driveway 10 years or older and doesn't cause any problems with the county road or drainage. 2. An existing home with only minor remodeling or repairs. SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF Doris F. Miller Document Date: August 17, 2005 State of Califomia County of ?(L 1,k SS. On �'1 dj , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Doris F. Miller e (or proved to me on the basis of satisfactory evidence) to be the person() whose name) istm subscribed to the %%!thin instrument and acknowledged to me that.helshcUlmy executed the same in +is/herMtt!lr authorized capacitykies%— and that by his/her/theirsignaturcW on the instrument the person(%), or the entity upon behalf of which the person(* acted, executed the instrument. WITNESS R1T&an­d'Wrd-6lTicia1 seal. Signature J. Br+ n. NWM PUMP; FOR NOTARY SEAL OR STAMP wscooN l:;7puc 51300 MFORIJIANR' Ci. lo, 2009'' MAIL TAX TAT ENTS TO : Same as Above BTECJGRANTDEED 2005-0049623 :- C 149CORDING REQUESTED H' Recorder: I REC FEE 10.08 Bidwell Title &Escrow Company Offtciai Records I TAX 63,88County of I Butte I J. 1 AND WHEN RECORDED MAIL, TO RecordSUBS County Clerk-Recorde:'I Nome Robert Marquez I I SA Strny /►dellen 1889 Stanford Ave :08 09MA 23 -Aug -,2086I I Page 1 of 2 Cay.Sna �IIi1 Ii1 iI 1l UIIIIIIIIIIIII�IIII ��ll IIII'IIIII „p Oroville CA 95966 o'aKN.. 00223687-001 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 069-220-046 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE 81, ESCROW COMPANY The Undersigned Grantar(s) Duclare(s) Documentary Transfer Tax is $63. 8 0 ❑ City/Town of ✓ computed on full value of interest or property conveyed, or ✓ Unincorporated Arca O full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Doris F. Miller, An Unmarried Woman hereby GRANT(s) to Robert Marquez and Kristyn Marquez, Husband and Wife as Joint Tenants the following real property in the ❑ City of ✓ Unincorporated Arca County of Butte, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF Doris F. Miller Document Date: August 17, 2005 State of Califomia County of ?(L 1,k SS. On �'1 dj , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Doris F. Miller e (or proved to me on the basis of satisfactory evidence) to be the person() whose name) istm subscribed to the %%!thin instrument and acknowledged to me that.helshcUlmy executed the same in +is/herMtt!lr authorized capacitykies%— and that by his/her/theirsignaturcW on the instrument the person(%), or the entity upon behalf of which the person(* acted, executed the instrument. WITNESS R1T&an­d'Wrd-6lTicia1 seal. Signature J. Br+ n. NWM PUMP; FOR NOTARY SEAL OR STAMP wscooN l:;7puc 51300 MFORIJIANR' Ci. lo, 2009'' MAIL TAX TAT ENTS TO : Same as Above BTECJGRANTDEED EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: Order No. 00223687-001 ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: LOT 226, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES UNIT NO. 311 , FILED IN THE OFFICE OF THE COUNTY RECORDER OF BUTTE COUNTY, CALIFORNIA, ON JULY 26,1974 IN BOOK 43 OF MAPS, AT PAGE(S) 44, 45, 46, 47 AND 48. AP NO. 069-220-046 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DMSION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 a007-0007-144 Recorded I REC FEE 7.88 Official Records I County of I ITMES 2,80 Butte I CkWDALE J. atim5 I Couky Clerk-Recorderl I i JC 011:603,112+eb-M7 I Page I of I AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for Agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: LOT 226, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES UNIT NO. 3", FILED IN THE OFFICE OF THE COUNTY RECORDER OF BUTTE COUNTY, CALIFORNIA, ON JULY 26,1974 IN BOOK 43 OF MAPS, AT PAGE(S) 44, 45, 46, 47 AND 48. AP NO. 069-220-046 Date "[ " PROPEF,:rY OWNERS: N State of California ) County of X66 T- "'( ) On 02 l bq t 200'7 before me, p�mG. M s personally appearedJOhtl MCAC906-L, PI y1a `NI • MGl✓ P.L r`1'D.r'IQ� ' K(i 1-1 Mersoacatly Imewn-to-me-(vr proved to me on thY basis of satisfactory evi ence) to be the person whose na e(s) ' re subscribed to the within instrument and acknowledged to me that hie/they executed the same in hisfheWtheir authorized capacity(ies), and that by hisAer/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand a d official seal. JANET G. FIORE TENNANT O&ISignature �T/y% Seal: 14A,MyComm. Commission # 1663858 g Notary Public - CcOonla 8 Camly Cres Jun 1, 201 A. P. # OG `a?a0 'Q�� a— �:,..,.,...t+zr ... , I r ..._i--• - a w.w rc:v• ^,,;r �x;� r. } Fx'°:*rr� tib.'.•..« �_,04sx,, , ., a.:+..,...... ri. , •t. �� BUTTE COUNTY SCHOOLS*IMPACT FEE CERTIFICATION FORM (One form per Building) School Districtv' :• Building Department No. Tax ate Area No. A.P. NumberQl �� O`O�� (�' � Jurisdiction: � City County Property Owner Property Location/Address 17cn �s�a�l�e or. Oroy' l k pA Subdivision Lot No. ................................................... _............................................ , Residential Development No of Living Mobile Hom_,::'—Addition/ s'Supplemental to Units Installation ConversionPe mitV# '(No foundation inspection) :........:........................................................................................ Commercial/Industrial 0 New Addition r Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage (Including Exterior , Roofed Areas). ' 2-f eJs41 Date Sq. Footage I (Group R) Cr. Demo - existing sq. ft. see attached Net total sq. ft. District Identification No. , if Z O 6r6� School District certifies that (Payor) _ 1-1 ke A-12 0 OY J'�- l 1-e °t SOL to G (Street Address) % (City) (State) (Zip Code) (Phone Number) has complied with the requirements of Resolution No. representing 1"1 `E Ck square feet. ocnooi uistnct �7 0 S —,o b— a ok by payment of $ 4S 5. 1. B 2926 $ FULL MITIGATION $ Paid by Check # Remarks: V (, q —Z10 0440 1-) % 9 )--ILD 3 --5--o 1 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 submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. H, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is noted 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 (school district), Yellow (building department), Pink (applicant) feeform.xls (12/06)dmm i LP BUTTE 9OUNTY DEVELOPMENT ELOI'MENT FEE CERTIFICATION FORM �f FEATHER.RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) 0 PARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD)- Assessor Parcel Number (s) C) COq + 9 0" ` q, �� Building Permit Number JOG 2335 Propeity Owner (s) Project Location /Address I� �ht (� jr_��r V�� �fi . I Subdivision Name Assessable Sq. Ftge Typ% of Residential Development (check one) New Development Single Family -Detached Single Family -Attached g Y Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified. by Building Department Comments: 102G*22;01�, NO �����1 �� 1. _��• :� �' � Number Mailing Address State Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ _ Remarks: Paid by Check No: 0-1 Paid by Cash: Recreation and Park District Representative KAF0RMS\81)n.n NnT FnP.MS\naflc-rec standard form rev Ldoc per unit for a total of $ per sq foot for a total of $ Receipt No: Zip PERMIT NO.: 08-07 Lake Oroville Area Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95966 (530) 53:9-2000, DISTRICT APPROVAL AND VERIFICATION OF BUILDING SEWERS INSPECTION This verification form must be submitted to the Butte County Department of Public Works Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval of a Building or an Occupancy Permit by Butte County, a copy of this verification form, signed off.by Lake Oroville Area Public Utility District, must be submitted to Butte County. Date: Applicant: Applicant Address: February 12; 2007 Robert Marquez 342 Mission Olive Rd., Oroville, CA 95966 Applicant Phone No.: (530) 589-0558 Property Locations(s): 176 Apache Circle Kelly Ridge Estate, Unit.3, Lot '#226 069-022-046 A. P. No.(s): Fees due: all fees paid as of 2/5/07. Application for service approved: `LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Date: Lake Oroville Area Public Utility District release to close permit: Date: By: ❑ - In Service ❑ - Locked Out White - Customer Green - Office Final Yellow - Customer Fina/ Pink - FOSFinai Gold -FOS REQUEST FOR CONNECTION -PERMIT APPLICATION FOR SEWER CONNECTION AND SERVICE FROM LAKE. OROVILLE AREA PUBLIC UTILITY DISTRICT hereinafter referred to as "Applicant', being the property owner or ow er'.s agent.desinng sewer service, hereby requests Lake Oroville Area Public Utility District, hereinafter referred to.as "District", to connect Applicants sewage disposal line to -District's sanitary sewer system and to provide sewerage service. Location of roe �1 ?GUS A.P.#: bbc L OZZ-04(0 P P rtY Subdivision: i4�ul t�S - �' Low Block#: ❑ Property Annexed ❑ Property Not Annexed ❑ Property Annexation in Progress Kind of Service: No. of E.D.U.'s this permit: Multiplication Factor: *Monthly Charges: Capacity Charge: Residential / ❑ Residence of Owner Connection Fee: ❑ Rental (single family) ❑ Rental (duplex) ❑ Apartment SC -OR Facility Charge: ❑ Industrial ❑ Commercial Total Amount Payable This Permit: •�<i�l ❑ Site plan reviewed ❑ Jobsite reviewed I The service applied for hereby shall be in accordance with the conditions hereinafter set forth and the ordinances, rules, 'regulations and policies adopted, or,to be adopted, by -the Board of Directors of District, all of which Applicant agrees to abide by and fully perform. Applicant agrees to pay for such service at. rates and charges as are established by District from time t6time. Signature -of Name of Owner if not Applicant Mailing Address of Applicant 5�� Mailing Address of Owner Phone # of Applicant: S Q Cy Phone # of Owner: CONDITIONS OF ACCEPTANCE OF. SEWERAGE SERVICE 1. In accepting this application, District does not hold itself liable to Applicant.for failure to perform any of the obligations imposed upon it or assumed by it under this application if such failure be caused by accident, Act of God, fire, strikes, riots, war, lack of capacity in SC -OR treatment/disposal plant or District's lines to handle the sewage or nay other cause beyond reasonable control of District. 2. Installation of the. sewer service line pertinent to. this application shall conform in all respects to District's specifications. 9 A // f--- ;n" 'cnna mafariale antyinpPrpd fill. and retaining walls shall be placed on the licant shall secure. permits) as: necessary from the County of Butte prior to doing any work„ 4. W including encroachment permits when work is within county right of way. 5. Installation of the subject sewer line. shall be at the 'sole cost and expense of Applicant. 6_ Actual connection of the subjectsewer service line to Districts sewer mainline shall be accomplished by District staff. 7. All work shall be inspected and approved by District 8. Subject to the.above conditions.a District Approval and Verification form may be issued as the District's permit. 9. This permit is valid for one (1) year. If work is not completed within said year, permit renewal will be required, together with payment of any increase in capacity fee, connection fee and/or SC -OR Facility Charge. Payment of Fees/Char9es required prior to final LAKE OROVILLE-AREA P.U.D. inspection. Payment received by-. Date: Receipt #. By. [J CASH (CHECK # (_ Date: $�, ZZS�Permit #: *Monthly charge payable at the current rate at time of connection. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** ARCHITECT/ENGINEER OWNER INFORMATION Last Name MW r irst Name Address G 1�� t City Phone State' Zip Phone SJ J Fax E-mail Page ARCHITECT/ENGINEER CONTRACTOR Name Address ` r CityState City ` 1 StateA. Zip Phone Fax Fax E-mail Fax Lic.#3SA677 Class ARCHITECT/ENGINEER Name 1 a5 vt. G Name Address p _ City ` 1 StateA. Zip G `J Phone , D ` Fax E-mail State License Number For office use only: APPLICANT INFORMATION Name Z� j Address L City I es Stat A— Zip I Phone Type Const. of Fax E-mail Map Book For office use only: OCATION Zoning I Z� j I Flood Zone SRA I es No Occ. 3 1 Type Const. of Subdivision Name Carrier Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT Q�D ' BP Description or Scope of Work: OCATION AP# � rOJECT ^ �r1 �[ U Property -Address l /q Cit O Cross St et WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 2,q v Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: ` �`S Bldg SJ, U� SRA Receipt #: B — �1- 3 -z Sheriff Date: Other q,-2rl -C)( I t� . Z Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer., or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The `request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 5-12-05