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BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(one Form per Building)
A.P. Number (x'71-++++��3�0-007Building Department No.
School District �/4eo-/41W City D County [N Jurisdiction
Property Owner C..ha0es Cad
Project Location/Address
Subdivision
Lot Number
Residential Development: 1-560
Sq. Footage
# of Living MHI Addition (Group R)
Units
Commercial/Industrial:
Sq. Footage
New Addition (Including Exterior
Roofed Areas)
ng Department Representative
it- a a - 01
Date
*******************************************************************
(Floor Plans reviewed by School District Personnel)
rict Id No.
ova'
C
School District certifies that
(Applicant N' ) (Phone Number)
(�,;�reet Addre §4\ I_
ty
State
has complied with "the requirements of Resolution No.
zip coae)
le"61 90
by the pay ent of $ '�� �. OU representing l,`J �Q square feet.
aa_/� )
Scho 1 District epresentative D to
PAID BY CHECK NO.
BANK NO 1 L L
PAID BY CASH
REMARKS:
white -applicant, yellow -building department, pink -school district'
SCHOOL.FEE (8/88)
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