HomeMy WebLinkAbout069-580-022BUTTE COUNTY SCHOOLS'DEVELOPMENT FEE'CERTIFICATION FORM
(One Form per Building)
A. P. Number 6 9- j8'•'-3� ';L_ Building Department No.
School District(()'(,6_1, JA &9,y7_"City F--l'
County Q Jurisdiction
Property Owner
Project Location/Address 'l.��Q¢ ✓ c.GcJ�,,.
Subdivision - Lot Number
.Residential Development:. /
` Sq. Fobtage l�Po1 7
# of Living MHI Addition (Group R)
Units - -
Commercial/Industrial: a Sq. Footage
New Addition (Including Exterior.
Roofed Areas)
E
Building -Department Representative
Date
(Floor Plans reviewed by School District Personnel)
E �J
District Id No.
/
School District
.
certifies that
dl-
_ (Applicant Name)
(Phone Number),
/1
(Street Address)
(City) (State)
(Zip Code)
has complied with - the requirements of ' Resolution No. 'F� - 7
by the' payment of $ representing
7 square feet.
40
1114
School Disx'j'.f t Representative -
Date/
PAID BY CHECK NO. REMARKS:
BANK NO -1-1 - Fd 7
PAID BY CASH -
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE •(8/88)
I