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HomeMy WebLinkAbout072-610-01611�4�-Icwoop Department C o u n t y J. Michael Crump, Director Warner C. Phillips, Assistant Director February 18, 2004 Worden Family Trust P.O. Box 5673 Oroville, CA 95966 Re: Certificate of Merger AP 072-610-016 & 018 Dear Mr. & Mrs. Worden: f Public 0 f B U t Works LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 BUTTE - COUNTY FEB 18 2004 DEVELOPMENT SERVICjS Enclosed please find the Certificate of Merger that was issued by the Butte County Department of Public Works and recorded on December 17, 2003, under Serial Number 2003-0087311, in the office of the Butte County Recorder. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, 9-k Stuart Edell 0 Manager, Land Development Division SE/kp Enclosure cc: /Building Division Environmental Health Dept. Reily Smith Michael Evans RECORDING REQUESTED BY and AFTER RECORDING RETURN TO: Butte County Public Works LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 LANDS BEING MERGED: Iffl III IIS I ILII I II I[I II I IIII IIII If 2P10(2) __3-C6108_/__3JL3- Recorded I REC FEE 28.00 Official Records I County Of I BUTTE I. CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Barbara 03:43PM 17 -Dec -21003 I Page 1 of 8 CERTIFICATE OF MERGER AP NUMBERS 072-610-016 & 0720610-018 NUMBER OF EXISTING PARCELS: T80_j2) EXISTING PARCELS CREATED BY: PARCEL MAP RECORDING DATA: YEAR 1978 BOOK / PAGE OR SERIAL NUMBER: 67 M 11 SUBDIVISION / PARCEL MAP: PARCELS 1 & 3 As of the date of recordation, those lands noted above are merged to create two 2 arcels of land as described in Exhibit(s) A, B attached hereto. � DECEMBER 16, 2003 MIKE CRUMP DATE Director of Public Works OWNERS' CONSENT TO MERGER THE UNDERSIGNED, as owners of all that real property to be merged, do hereby consent and agree to the merger of such lands into that / those parcel(s) as described inExhibit(s) A,. B attached hereto. OWNERS SIGNA TURES MUST BE NOTARIZED - Print name and title (if applicable) below signature line paj Paul E. Worden, Trustee of The Worden Family Trust, Date U.D.T. ("Under Declaration of Trust'), Dated March 13, 1991 Vomelda C. Worden, Trustee of The Worden Family Trust, Date U.D.T. ("Under Declaration of Trust'), Dated March 13, 1991 Bank of America NT , a National Banking Association BY: - neficiaryjj o . Butte Federal Credit Union BY: Be ficiary ��,,,,� �.Y• P /%%vue�h-�,� alv,aoo3 Date 122 2 3 Date 9,� Dated } STATE OF e j%+ `�� }SS. COUNTY OF 2_at�,Gy } On 41,> (%t,'( be r .-2 4',,,90J 3 before me, 4Z -12 t LQ (', J M s A1, �j personally appeared J /t 2 y2Zi4 /ASO/( z , pers ally lrnown to me or proved tome on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signa- tures) on the instrument the person(s) or the entity upon behalf of which WAYVE C. ES the person(s) acted, executed the instrument. NOTARY PUBLIC Commonwealth of Virginia WITNESS my hand d official se NIX Commission Expires Oct. 31, 2006 Signature (This area for official notarial seal) Dated .2, AC .0 . [G.(.( f) } STATE OF CALIFORNIA )SS. COUNTY OF personally known to me (o ry o*Weflee) to be the person(?) whose name(g) Ware. subscribed to the within instrument and acknowledged to me that he/she#hcy executed the same in his/herftit0ir authorized capacity(ies), and that by his/he»4heir signa- USA E. L. SECRIST Commkok)n # 1444691 Ii IitureS,s�J on the instrument the person(?') or the entity upon behalf of which Nary i wft - CGROm10 BUBOcourdy the personv) acted, executed the instrument. ?L1;0;Z Eywes Nov 6, 2007 pwqpww WITNESS my h nd and official seal. Signature (This area for official notarial seal) Dated STATE OF CALIFORNIA COUNTY OF Butte )SS. } On December 5, 2003 before me, Michelle 9A. Miller, Notary personally appeared Paul E . ' Worden and Romelda C. Worden personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signa- ture(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS and offic' l eal. Signature Lam`' Dated STATE OF CALIFORNIA COUNTY OF before me, personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signa- tures) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature MICHELLE A. MILLER Commission #1351456 0 Notary Ptotic -California M 800 County My Comm. Exp. APA. 15, 2006 9002 `Sf 'ddy 'dx3 'wwoo Ayy /llunoo aun8 A CL 91tupplE:. oil4nd AWN 'o U ggytgCL uOISSIWW03 0 win In V 3l13H01VV (This area for official notarial seal) (This area for official notarial seal) The following legal description was written to describe the new "merged" parcel I for Worden, APN 072-610-016 & 018: EXHIBIT "A" All that certain real property situated in the unincorporated area of Butte County, California, being a portion of Parcels 1 and 3, as shown on that certain Parcel map, recorded in the Office of the Recorder of the County of Butte, State of California, on May 24, 1978, in Book 67 of Maps, at Page 11 and being more particularly described as follows: Commencing at a'/2" rebar set for the Center IA Corner of Section 24, Township 19 North, Range 5 East, Mount Diablo Meridian per said Parcel Map; thence, South 89 degrees 19 minutes 21 seconds West, a distance of 1314.59 feet; thence, South 00 degrees 27 minutes 33 seconds East, a distance of 247.20 feet; thence North 89 degrees 32 minutes 27 seconds East, a distance of 380.00 feet to the POINT OF BEGINNING; thence along the following numbered courses: 1) continuing North 89 degrees 32 minutes 27 seconds East along said line, a distance of 194.56 feet; 2) thence, South 07 degrees 57 minutes 14 seconds East, a distance of 1174.58 feet; 3) thence, South 00 degrees 00 minutes 00 seconds East, a distance of 350.00 feet; 4) thence, North 90 degrees 00 minutes 00 seconds West, a distance of 150.00 feet; 5) thence, North 56 degrees 15 minutes 47 seconds West, a distance of 242.25 feet; 6) thence, North 44 degrees 00 minutes 00 seconds West, a distance of 150.00 feet; 7) thence, North 46 degrees 00 minutes 00 seconds East, a distance of 150.00 feet; 8) thence, North 00 degrees 27 minutes 33 seconds West, a distance of 1165.12 feet to the POINT OF BEGINNING. TOGETHER WITH AND RESERVING THEREFROM: a right-of-way for road and public utility purposes as shown on said Parcel Map, recorded in Book 67 of Maps, at page 11. ALSO RESERVING THEREFROM: an easement for well and water pipeline facilities on, over and under a strip of land 15.00 feet in width lying 7.50 feet on each side of the existing well and water pipeline as located on said Parcel 3; thence, southeasterly along said water pipeline to the South line of the above described parcel for the benefit of the land described in Exhibit `B" attached. END OF DESCRIPTION Containing 10.000 acres, more or less. The Basis of Bearings for this description is the same as shown on said Parcel Map recorded in Book 67 of Maps, at page 11. Page 1 of 2 All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. fi xPI ag!5 N�9q (SO 0 `�Q �F�F GAIIE��� Prepared: Dec. 1, 2003 Page 2 of 2 The following legal description was written to describe the new "merged" parcel 3 for Worden, APN 072-610-016 & 018: EX MIT "B" All that certain real property situated in the unincorporated area of Butte County, California, being a portion of Parcels 1 and 3, as shown on that certain Parcel map, recorded in the Office of the Recorder of the County of Butte, State of California, on May 24, 1978, in Book 67 of Maps, at Page 11 and being more particularly described as follows: Beginning at a'/2" rebar set for the Center'/4 Corner of Section 24, Township 19 North, Range 5 East, Mount Diablo Meridian per said Parcel Map; thence, along the following numbered courses: 1) South 00 degrees 28 minutes 12 seconds East, a distance of 2170.67 feet, to the point of a non -tangent curve, concave to the North, having a radius of 170.00 feet and a central angle of 11 degrees 33 minutes 54 seconds (record of 11 degrees 33 minutes 24 seconds) and a chord of 34.26 feet bearing North 82 degrees 48 minutes 30 seconds West; 2) thence, West along said curve, a distance of 34.31 feet (record of 34.29 feet); 3) thence, North 77 degrees 02 minutes 42 seconds West, a distance of 219.40 feet; 4) thence, North 77 degrees 06 minutes 34 seconds West, a distance of 321.87 feet to the point of curvature of a tangent curve, concave to the South, having a radius of 230.00 feet and a central angle of 07 degrees 40 minutes 31 seconds (record of 07 degrees 40 minutes 35 seconds); 5) thence, West along said curve, a distance of 30.81 feet; 6) thence, North 84 degrees 46 minutes 53 seconds West, a distance of 43.81 feet to the point of curvature of a tangent curve, concave to the South, having a radius of 180.00 feet and a central angle of 36 degrees 48 minutes 45 seconds (record of 36 degrees 48 minutes 43 seconds); 7) thence, West along said curve, a distance of 115.65 feet; 8) thence, South 58 degrees 24 minutes 24 seconds West, a distance of 88.53 feet to the point of curvature of a tangent curve, concave to the North, having a radius of 95.00 feet and a central angle of 18 degrees 29 minutes 51 seconds (record of 18 degrees 30 minutes 00 seconds); 9) thence, West along said curve, a distance of 30.67 feet; 10) thence, South 76 degrees 54 minutes 24 seconds West, a distance of 22.12 feet to the point of curvature of a tangent curve, concave to the Northeast, having a radius of 45.00 feet and a central angle of 95 degrees 35 minutes 41 seconds (record of 95 degrees 35 minutes 45 seconds); 11) thence, Northwest along said curve, a distance of 75.08 feet; 12) thence, North 07 degrees 29 minutes 51 seconds West, a distance of 98.20 feet to the point of curvature of a tangent curve, concave to the Southwest, having a radius of 270.00 feet and a central angle of 30 degrees 42 minutes 53 seconds (record of 30 degrees 42 minutes 55 seconds); 13) thence, Northwest along said curve, a distance of 144.74 feet; Page 1 of 3 14) thence, North 38 degrees 12 minutes 46 seconds West, a distance of 175.40 feet to the point of curvature of a tangent curve, concave to the Southwest, having a radius of 205.00 feet and a central angle of 33 degrees 53 minutes 38 seconds (record of 33 degrees 53 minutes 40 seconds); 15) thence, Northwest along said curve, a distance of 121.27 feet; 16) thence, North 72 degrees 06 minutes 27 seconds West, a distance of 124.29 feet; 17) thence, North 00 degrees 27 minutes 33 seconds West, a distance of 90.05 feet; 18) thence, North 89 degrees 32 minutes 27 seconds East, a distance of 30.00 feet to the point of curvature of a non -tangent curve, concave to the Southeast, having a radius of 125.00 feet, a central angle of 85 degrees 37 minutes 28 seconds (record of 85 degrees 37 minutes 23 seconds), and a chord of 169.90 feet bearing North 42 degrees 21 minutes 06 seconds East; 19) thence, Northeast along said curve, a distance of 186.80 feet; 20) thence, North 85 degrees 09 minutes 50 seconds East, a distance of 95.00 feet to the point of curvature of a tangent curve, concave to the South, having a radius of 225.00 feet and a central angle of 37 degrees 24 minutes 28 seconds; 21) thence East along said curve, a distance of 146.90 feet; 22) thence, South 46 degrees 00 minutes 00 seconds West, a distance of 150.00 feet; 23) thence, South 44 degrees 00 minutes 00 seconds East, a distance of 150.00 feet; 24) thence, South 56 degrees 15 minutes 47 seconds East, a distance of 242.25 feet; 25) thence North 90 degrees 00 minutes 00 seconds East, a distance of 150.00 feet; 26) thence, North 00 degrees 00 minutes 00 seconds East, a distance of 350.00 feet; 27) thence, North 07 degrees 57 minutes 14 seconds West, a distance of 1174.58 feet; 28) thence South 89 degrees 32 minutes 27 seconds West, a distance of 194.56 feet; 29) thence, continuing South 89 degrees 32 minutes 27 seconds west, a distance of 380.00 feet; 30) thence North 00 degrees 27 minutes 33 seconds West, a distance of 247.20 feet; 31) thence, North 89 degrees 19 minutes 21 seconds East, a distance of 1314.59 feet to the POINT OF BEGINNING. TOGETHER WITH AND RESERVING THEREFROM: a right-of-way for road and public utility purposes as shown on said Parcel Map, recorded in Book 67 of Maps, at page 11. ALSO TOGETHER WITH: an easement for well and water pipeline facilities on, over and under a strip of land 15.00 feet in width lying 7.50 feet on each side of the existing well and water pipeline as located on said Parcel 3; thence, southeasterly along said water pipeline to the South line of the Parcel of the land described in Exhibit `B" attached. END OF DESCRIPTION Containing 39.741 acres, more or less. Page 2 of 3 The Basis of Bearings for this description is the same as shown on said Parcel Map recorded in Book 67 of Maps, at page 11. All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. Prepared: Dec 1, 2003 Page 3 of 3 END OF DOCUMENT RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPlY of Document Recorded 03 -Mar -2004 2004-0011942 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. SCOTT WORDEN 7 COUNTY CENTER DRIVE REAL PROPERTY OWNERILESSOR OROVILLE BUTTE CA' P.O. BOX 5673 CITY COUNTY STATE ZIP - MAaJNG ADDRESS 538-7541 BUILDINERMIT NO. TELEPHONE NUMBER OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 331 BLACK BART RD 91265 INSTALLATION MAILING ADDRESS, IF DIFFERENT DEALER LICENSE NO. OROVILLE BUTTE CA 95966 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME " MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA' 95965 CITY COUNTY STATE ZIP - 04 -0018 530 538-7541 BUILDINERMIT NO. TELEPHONE NUMBER SI OF LOCAL GENCY OFFICIAL DATE SKYCREST ENTERPRISES DEALER NAME (if not a dealer sale, write "NONE") 91265 DEALER LICENSE NO. SKYLINE HOMES INC. 2004 WESTBROOK 4820 CT MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMF/NUMBER 8V-70-0437-S-A/B/C 473"X39' TTT T CC )AA A le I/ REAL PROPERTY LEGAL Dp CILLMON ASSESSORS PARCEL NUMBER AP # 072-610-016 SEE ATTACHED HCD FORM 433(A) REV. 8/91 ;DEC -18-2003 14:19 FROM:STAPLES 0816 5305331399 T0:3439496 P.3/4 EXHIBIT "A" BIFORNIA, D TO HEREIN IS SITUATED IN THE STATE OF CAL THE LAND BUTTE AND IS DESCRIBED AS FOLLOWS: COUNTY OF BUTTE, oEA nRCE_ I: PROPERTY SITUATED IN THE UNINCORPORATED3�AS ATL THAT CERTAIN CREAL ALIFORNIA, BEING A PORTION OF PARCELS 1 AND OF BUTTE COUNTY, CAL RECORDED IN THE OFFICE OF THE SHOWN ON THAT CERTAIN PARCEL 'STATE OF CALIFORNIA' ON MAY 24, ORE RECORDER OF THE COUNTY OF BUTTE' PAGES) 11, AND 19781 IN BOOK 67 OF MAPS, PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT A 1/2" REBAR SET FOR THE CENTER QUARTER CORNER OF SECTION 24, TOWNSHIP 19 NORTH, RANGE 5 EAST, M.D.B. & M., PER SAID PARCEL MAP; THENCE SOUTH 890 19' 2111 WEST, A DISTANCE OF 1314.59 FEET; THENCE SOUTH 000 27' 3311 EAST, A DISTANCE OF 247.20 FEET; THENCE NORTH 890 32' 2711 EAST, A DISTANCE OF 380.00 FEET TO THE POINT OF BEGINNING; THENCE ALONG THE FOLLOWING NUMBERED COURSES: 1) CONTINUING NORTH 890 32' OF 194.56 FEET; 2) THENCE SOUTH 070 57' 1411 3) THENCE SOUTH 00' 00' 0011 4} THENCE NORTH 900 00' 0011 5) THENCE NORTH 560 15' 47" 6) THENCE NORTH 440 00' 00" 7) THENCE NORTH 460 00' 0011 8) THENCE NORTH 000 27' 33" THE POINT OF BEGINNING. 27" EAST ALONG SAID LINE, A DISTANCE EAST, A DISTANCE OF 1174.58 FEET; EAST, A DISTANCE OF 350.00 FEET; WEST, A DISTANCE OF 150.00 FEET; WEST, A DISTANCE OF 242.25 FEET; WEST, A DISTANCE OF 150.00 FEET; EAST, A DISTANCE OF 150.00 FEET; WEST, A DISTANCE OF 1165.12 FEET TO RESERVING THEREFROM A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES AS SHOWN ON SAID PARCEL MAP, RECORDED IN BOOK 67 OF MAPS, AT PAGE(S) 11. ALSO RESERVING THEREFROM AN EASEMENT FOR WELL AND WATER PIPELINE FACILITIES ON, OVER AND UNDER A STRIP OF LAND 15.00 FEET IN WIDTH LYING 7.50 FEET ON EACH SIDE OF THE EXISTING WELL AND WATER PIPELINE AS LOCATED ON SAID PARCEL 3; THENCE SOUTHEASTERLY ALONG SAID WATER PIPELINE TO THE SOUTH LINE OF THE ABOVE DESCRIBED PARCEL FOR THE BENEFIT OF THE LAND DESCRIBED IN EXHIBIT "B" ATTACHED, ON THAT CERTAIN CERTIFICATE OF MERGER RECORDEDDts. CJD 01 UNDER BUTTE COUNTY RECORDER'S SERIAL NO. .7311 ' . PARCEL HEREIN IS PURSUANT TO A LOT LINE ADJUSTMENT-APPROVEDBY THE REC �DOFQ BUTTE,14, a S OWWN AS PARCEL A, IN CERTIFICATE OF MERGER NO. _ dlO 7�JJ , UNDER BUTTE COUNTY RECORDae, 71 00 ER'S SERIAL PORTION OF APNS 072-610-016-000 AND 072-610-018-000 CONTINUED. 11 ,DEC -1B-2003 14:20 FROM:STAPLES 0816 EXHIBIT "A" - CONTIMMD PARCEL II: e 5305331399 T0:343B496 -t A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 24, 1978, IN BOOK 67 OF MAPS, AT PAGE(S) 11. 191719.DES P. 4/4 '�i X e e `'� d t 11` * y: 3.. aRlffi%kul,l ca BUILDING, PERMIT NUMBER: 04-0018 Address or location of unit: 331 BLACK BART RD., OROVILLE CA 95966 Legal Description of Real Property: AP # 072-610.-016 _ SEE ATTACHED (x) Mobilehome/Manufactured Home O •Commercial Coach Has been affixed to the real property above by installation_ on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: SCOTT.WORDEN ` Owner's address: P.O. BOX 5673, OROVILLE CA95965 INSIGNIA OR HUD NUMBER: ULI 553944/5/6 SERIAL NUMBER OR V.I.N.: '8V-70=0437-S-A/B/C MANUFACTURER'S NAME: SKYLINE HOMES INC. YEAR:)8n4 OFFICIAL APPROVING INSTALLATION: DATE: P . `7 - PHONE: (530) 538-7541 H.C.D. 513C BUSINESS,TRANSPORTATION,f}I(�Q1�O1��$�NGAGENCY <t• t .DEPARTMENT OF HOU 1NO.AND.'�QMAIRAIJ�IMY. DEVECOPMENT .. ;:....'..;....Q, .. . r DIV19fON O BODE ANtf'�YANtlAlib6 �/ � %o 3 MANUFACTUREOH0118.IN(j'PROG.RA1A.: lR9lANUFACTURER`CtRTi. KATE ®F ORIGIN J1419U N: 'ORIGINAL (PINK) ' FORWARO TO THE INVENTORY CREDITOR. UNLESS THERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828. SACRAMENTO, CA 95612-1828, wTHiN FIVE (5) DAYS UP RELEABE. COPY 2 (YELLOAJ DELIVER TO THE TRANSPORTER TO ACCOMPANY TME UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER. urn aa -%.,A - rile , .,7f!47, 'CHECK 1F TH19 FS,A DUPLICATE MCO -ENTER ORIGINAL MCO'NO. MAN 1FACTURED HOME OR MULTI -UNIT MANUFACTURED HOUSING ® SFO (SINGLE FAMILY DWELLING) ® MUMH (MULTI -UNIT MANUFACTURED HOUSING NUMBER OF 3 TRANSPORTABLE SECTIONS COMMERCAAL COACH: OCCUPANCY GROUP MANUFACTURER NAME: MANUFACTURER LICENSE NUMBER: SKY'L1N•E HOMES INNS 90002 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: EAST NEAMEI: STREET WOODLAND CA 95776r $ 98,285.50 $11E7'20 State MANUFACTURER TRADE NAME: -MODEL NAME AND/OR NUMBER: 'GATE OF'MANUFACTURE: WESTBWOK 4820—CT 2/6/2004 NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. DEAL R NUMBER OR DATE OF TRANSFER: TRANSFEREE DESIGNATION: -SKYCREST ENTERPRIStS/'COUSIN G�;RY' S. HOMES 2/1-2/2004 1 265 DEALER OR TRANSFEREE ADDRESS: 3 68 HW:' 99 1, C 0 CA 5� Stale) (zip) INVENTORY CREDITOR NAME: TEXTRON FINANCIAL CORP INVENTORY CREDITOR ADDRESS: P.O. BOX 16520 ST -••LOUIS MO 63105 street Ci) (S ate) z SECTION MANUFACTURER SERIAL NUMBER NCD INSIGNIA OR MUD LABEL NUMBER LENGTH WIDTH WEIGHT 1 70 'INCHES INCHES (POUNDS 1. 8V -7.0 -0437—S -C ULI 553944 57'6 156 19,974 2 8V -70-0437-9—B ULI 553945 '576 156 19,724 SV-70-0437—S—A ULI 553946 576 156 20,754 TRANSPORTER NAME: ' BE"ETT TRUCK TRANSPORT TRANSPORTER ADDRESS: P.O. BOX 179 U'CTRHAri CA 95938 street IGh l6teto171.1 DESTINATION FOR UNIT DESCRIBED ABOVE' NAME COUSIN GARY Is HOMF.S street 13468 HW'Y 99 E (CQJRICO CA Slmte 9597.3 1 mrtAy uneet Pehany d perjury unCBt lho lows of the State o1 Call(Om16 that the nave IeCte are uue end Imnecl. E.mmaoon, 2/1'2. 2004 at -WOODLAND YOLO CA (Data) - (Chy) (Covnty)(tmle) _77 SIGNATURE OF AUTHORIZED AGENT: r-, — J1419U N: 'ORIGINAL (PINK) ' FORWARO TO THE INVENTORY CREDITOR. UNLESS THERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828. SACRAMENTO, CA 95612-1828, wTHiN FIVE (5) DAYS UP RELEABE. COPY 2 (YELLOAJ DELIVER TO THE TRANSPORTER TO ACCOMPANY TME UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER. urn aa -%.,A - rile , .,7f!47, ;tv-�STATE OF CALIFORNIA s DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS • REGISTRATION AND TITLING'SECTION STATEMENT OF FACTS ;s unit is a: aj Mobilehome 0 Commercial Coach Floating Home True: r.�•.co _al (License) No.(s) Trade Name ISerial No.(s) _ ���'��b�vo A - Sl'eaia er ,'?, ;,he undersigned, hereby state that the unit described above: -Y P16z-c- e_J Of—) 0— a4) '01 r0 a r"Y;L��(0v� =fiant further agrees to indemnify and save harmless the Director of Housing and Communit: •;elopment, State of California, and subsequent purchasers of said unit, for any loss the. �x suffer resulting from registration of the above-described unit in California, or f,orr :;-fiance of a California certificate of title covering. the same, 'de certify under penalty of perjury that the foregoing is true and correct. ecuted on at (Date) (City) (State) :y.nature of each affi nt rl,' , i'y -;"D 476.6 (Rev 11/86) Printed name of each affiant 140 State DEC -18-2003 14:19 FROM:STAPLES 0B16 5305331399 RECORDING REQUESTED BY Order No. Escrow No. WHEN RECORDED 1%4AIL TO: SCOTT WORDEN P.O. BOX 5673 OROVILLE, CA. 95965 TO:3438496 P.2/4 COPY of Document Recorded 18 -Dec -2003 2003-0087557 Has not been compared with original BUTTE COUNTY RECORDER DOCUMENTARY TRANSFER TAX $....0».»... Computed on the consideration or value of property conveyed; OR D �. T 1 E Computed on the consideration or value less liens or encumbrances ;ignature o f Declarant or Agent determining tax - f rtn Name 11911 remaining at time of sale. GIFT' DIED R & T 11911 GRANT DEED APN: 072-610-016&018 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged. PAUL E. WORDEN AND ROMELDA C. "UNDER DECLARATION N OF TRUTRUSTEES OF ST ") , WORDEN FAMILY TRUST, U.D.T. . DATED MARCH 13,1991 hereby Grants) to SCOTT WORDEN, A MARRIED MAN AS SIS SOLE AND SEPARATE PROPERTY the real property in the City of - UNINCORPORATED AREA State of California, described as County of Butte SEE ATTACHED EXHIBIT "A" Dated December 18, 2003 STATE OFC Buff@ )SS. COUNTY OF a On December 18, 2003 before me, Michelle A. Miller NOtbr personally appeared Paul E. Norden and Romelda C. Worden personally known to file (or proved to the on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hia/her/their authorized capacity(ies), and that by his/her/their signa- tures) on the instrument the persons) or the entity upon behalf of which The person(s) acted, executed the instrument. W11 NESS my hand and official seal a I signature �A WORDEN FAMMY TRUST, U.D.T. PAUL E. WORDEN TRUSTEE Q--6M-EMA C. WORiDEN TRUSTEE AAICHELLE A. MlLLeR Commission #1351468 PublicC-- Ca lb t& My Comm. Exp. AP Fi 15, 2008 (This arca for official notarial seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE DEC -18-2003 14:19 FROM:STRPLES 0816 5305331399 TO:3438496 ;. P.3/4 EXHIBIT "A" IFORNIA, D TO HEREIN IS SITUATED IN THE STATE OF CAL E Lp�ND REFERRE AND IS DESCRIBED AS FOLLOWS COUNTY OF BUTTE, vs+RCEL _I AS AREA ION OF PARCELS 1 AND 3'THE EAI, PROPERTY SITLIAT oRTN TKE UNINCORPORATED ALL THAT CERTAIN REAL IA, BEING A P IN THE OFFICE OF BUTTE COUNTY, CEL MAP, RECORDED CALIFORNIA' ON MAY 24, SHOWN ON THAT CERTAIN PAR STATE OF CAL AND BEING MORE RECORDER OF THE COUNTY OF BUTTE, AT PAGES) 11, 19781 IN BOOK 67 OF MAPS, PARTICULARLY DESCRIBED AS FOLLOWS: ER R OF COMMENCING AT A 1/2" REBAR SFT FOR THE CENTM D4B & uARTM. CPE�R PER SECTION 24, TOWNSHIP 19 NORTH, RANGE 5 , SAID PARCEL MAP; THENCE SOUTH 89' 19' 21" WEST, A DISTANCE OF 1314.59 FEET; THENCE SOUTH 00° 27' 33++ EAST, A DISTANCE OF 247.20 FEET; THENCTANCE OF POINTEOFORTH 890 BEGINNING; THENCE ALONG THE FOLLOWING 38 FOLLOWINGNUMBERED COURSES' 1) CONTINUING NORTH 890 32' DISTANCE OF 194.56 FEET; WEST, A DISTANCE 2) THENCE SOUTH 070 57' 14" 3) THENCE SOUTH 000 00' 00" 4) THENCE NORTH 900 00' 00" 5) THENCE NORTH 560 15' 47" 6) THENCE NORTH 440 00' 00++ 7) THENCE NORTH 460 00' 001+ 8) THENCE NORTH 000 27' 33" THE POINT OF BEGINNING. 27" EAST ALONG SAID LINE, A DISTANCE EAST, A DISTANCE OF EAST,.A DISTANCE OF WEST, A DISTANCE OF WEST, A DISTANCE OF WEST, A DISTANCE OF EAST, A DISTANCE OF WEST, A DISTANCE OF 1174.58 FEET; 350.00 FEET; 150.00 FEET; 242.25 FEET; 150.00 FEET; 150.00 FEET; 1165.12 FEET TO RESERVING THEREFROM A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES AS SHOWN ON SAID PARCEL MAP, RECORDED IN BOOK 67 OF MAPS, AT PAGE(S) 11. ALSO RESERVING THEREFROM AN EASEMENT FOR WELL AND WATER PIPELINE FACILITIES ON, OVER AND UNDER A STRIP OF LAND 15.00 FEET IN WIDTH LYING 7.50 FEET ON EACH SIDE OF THE EXISTING WELL AND WATER PIPELINE AS LOCATED ON SAID PARCEL 3; THENCE SOUTHEASTERLY ALONG SAID WATER PIPELINE TO THE SOUTH LINE OF THE ABOVE DESCRIBED PARCEL FOR THE BENEFIT OF THE LAND DESCRIBED IN EXHIBIT "B" ATTACHED, ON THAT CERTAIN CERTIFICATE OF MERGER RECORDED Do -C, ) 4. a0D3 , UNDER BUTTE COUNTY RECORDER'S SERIAL NO. A063-573/1 PARCEL HEREIN IS PURSUANT TO A LOT LINE ADJUSTMENT APPROVED BY THE COUNTY OF BUTTE, SHOWN AS PARCEL A, IN CERTIFICATE OF MERGER RECORD D O o 003 , UNDER BUTTE COUNTY RECORDER'S SERIAL NO. d + t . - ill PORTION OF APNS 072-610-016--000 AND 072-610-018-000 CONTINUED DEC -18-2003 14:20 FROM:STRPLES 0816 5305331399 • TO:3438496 P.4/4 EXHIBIT "A" - CONTIMMD PARCEL II: A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 24, 1978, IN BOOK 67 OF MAPS, AT PAGE(S) 11. 191719. DES • fi� OFFICE COPY Address } ELECTRIC Meter By Dat e% rLJOB FINALED (Da 7-U Signature NOTES RESIDENTIAL, I SPECIAL CONDITIONS 072-610-016 04-0018 3 PERMIT NO. �, WORDEN PAUL '4 (' BLACK BART RD, OROVILLE .33 Cont: SKYCREST ENTERPRISES CHECKED MH PERM FND NEW SITE { , a mt a!� THE HCD FORM 433A FOR THIS MH CANNOT BE F RECORDED UNTIL ONE OF THE FOLLOWING HAS - ' BEEN TURNED IN TO THE BUILDING DIVISION: i (1) LICENSE PLATE(S) OR DECAL (THE ' ` INSPECTORMUST RETREIVE). . " (2) STATEMENT OF FACTS (ONLY ON NEW "YMH'S):. - INSPECTOR TO VERIFY'SERIAL & LABEL #'S: ' • fi� OFFICE COPY Address } ELECTRIC Meter By Dat e% rLJOB FINALED (Da 7-U Signature c I SPECIAL CONDITIONS CHECKED { • fi� OFFICE COPY Address } ELECTRIC Meter By Dat e% rLJOB FINALED (Da 7-U Signature SPECIAL CONDITIONS CHECKED BY , a SRA a!� FLOOD CERTIFICATE REQ. ..r FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS ' VERIFY`w USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER • fi� OFFICE COPY Address } ELECTRIC Meter By Dat e% rLJOB FINALED (Da 7-U Signature J=OK 0 = Not OK . = NotReadyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s I Card B-1 Date 1. Zoning Requirements -Setbacks -Easements j Date 2. Soils; Special MH Support Sketch Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 3. Sewer; Location -Test -Fall -C/O -Concrete Q10-1zoning Requirements -Setbacks -Easements 4. Water; Location -Test -Easement Needed (Sketch) Carports; Windows -Doors 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete t Electric s 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /" L "ft./ • P LPG ocking 7. Well Clearance & Disconnect 10. 8. Utility Clearance 11. Ext.; Steps -Doors -Landings Electricity; MH Test Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line zits 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector Verify #'s with Office 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8.. Gas and Electricity Tagged A_ Card B-1 Date 9. Tie Downs -Type -Installation Cert. Date 10. Exits; Insp.-Sketch Card B-1 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PER ENT END SYSTEM (ONLY) Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Q10-1zoning Requirements -Setbacks -Easements 6. Carports; Windows -Doors Footings; Size -Spacing -Marriage Line Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses ocking Siding; Nailing -Veneer -Stucco -Mesh 10. alve 11. Ext.; Steps -Doors -Landings Electricity; MH Test Braced Wall Panels mater; MH Test Water and Sewer Conne ed 8. Gas_an agged zits Li nse Decals Verify #'s with Office Date A_ Card B-1 Date Card B-1 Date Card B-1 ' Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining • 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s Hangers -Post Caps -Anchors -Connectors 1. Zoning -Setbacks -Easements -Flood -Slope Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth Fireplace Ties or Type A Flue -Fireplace Throat Clearance 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 5. Stemwalls, Main; Steel-Blockouts-Wrapped Garage Fire Protection Framing -RC Channel 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Property Line Firewall & Openings 6a. Hold Downs and Special Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 7. Slab, Steel -Wrapped Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 8. Piers -Fireplace Ftg.-Steel 57. 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 58. 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 59. Glazing Area -Glass Protection -Skylights -Plastic 11. Water Pipe; Test -Anchors -Regulator -Service Test Shear Walls; Nailing -Bolts 12. Electric Underground Brace Interior/Exterior Wall Panels 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection _ 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 87. Water Well, Disconnect, Electrical, Plumbing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Date 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Date 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No Date 32. Service -Riser Conductors & Ground Main Disconnect Comments at Final: 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive O Yes O No/Walks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: �'+'C'v„"'r.-^r'„�:.^r--.A r.:.... ,•, T�,...{,,.,, :3..,. t. :...j.� :`.`,r�^J�.+*-....*ti �Aisl,;,, "'u'.'?-�'�«F! �**:,::... r!.�. COUNTY OF BUTTE r' BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 —4 7 County Center Drive • Oroville, CA • (530) 538-7541 °- CORRECTION NOTICE OWNER PERMIT NO. r< A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. /- ems. h U i /X.f _ i2v c oy Cx // QS _-S S:d-r %s 'A Date Inspector REV t /92 r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 (Rev. 12/96) APPLICATION AND PERMIT ��yU ASSESSOR PARCEL NUMBER 072-610-016 ZONING BUILDING PERMIT OWNER WORDEN PAUL TELEPHONE - Sp, FT, OCC. BUILDING VALUATION OWNER'S MAIUNG ADDRESS PO BOX 5673 1832 R 98 928.00 40 C 520.00 CONTRACTOR'S NAME SKYCREST ENTERPRISES TELEPHONE 1342-2694 CONTRACTORS MAILING ADDRESS 13468 HW 99 CHICO CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $99 44,9_00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $319.75 Plan Checking Fee $ BUILDING ADDRES B Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE 39.35AC SF ❑ Duplex ❑ MobilehomeA Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ,M Other ❑ Describe Work: i'hV MH PERM FM NEW SITF Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 15.0 Mobile Home IS I GI W @20.00 PERMIT FEE $ 69-00 SNOW LOAD: 1500-2000ft. FLOOD:X 1050C SE ELECTRICAL PERMIT Fling Fee 20.00 ° Main Service A OR 1 23.001 23.00 LICENSED CONTRACTOR'S DECLARATION 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 1 in it rce and effect. �i. License Class Lic. No. �� / '� OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason4-3.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' ompensation, as provided for by section 3700 of the Labor Code, for the performanceof the work for which this permit is issued. have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' s n insurape carrnd policy number are: Carrier ier Policy Number / (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers'D compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with se provisions. X �X� Date — ure of Applicant - ❑ 0 er ❑ Contractor ❑ Agent OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46.00so CCU000A NEW CONST. DWEWNG OCCUP. SO DWE200ALLING OR ADDNS. ( 8 ACC. BUDS. 3.5QFr. �NioN-RES'.. MULTI.OUT 97.50 vOWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAL@';50 FlXED APPLNS. OR Ex. Occup. ourLErs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TO L F& $/470._ 75 IM FL D P H ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do indicated above for which fees have been paid. By D to PERMIT EXPIRES ON D e work Receipt No. // WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR/ GOLDENROD -APPLICANT V,COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541afteno V1 -I P M 2/96), APPLICATION AND PERMIT SESSORPAACEL NUM , - - - ZONG .� BUILDING PERMIT R ?�^ ✓ TELEPHONE SQ. FT. OCC. BUILDING VALUATION - OWNERS MAILING ADORES CI y 2,3 p/� CONTRACTOR'S NAME n Aj _ /_ �% -� _ _ e _ T°r'9NE, o� V I LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER ARCHITECT OR ENGWEERS MAILING ADDRESS BUILDING ADDRESS LOT NO. SUB NIS IONS NAME Co v (UUSEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other New ❑ Addition N NO. 3x1.3 5 A Total Valuation is Filing Fee $ Permit Fee�-- $ Plan Checking Fee $ Energy Plan Checking Fee $ $ PERMIT FEE $ PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Building sewer Mobile Home I S G I W /Xa IV �� ) - V PERMIT FEE S SdV �o�.� -T-e>2utic- ELECTRICAL PERMIT ow LdD 15 Vv OOOV OR LESS Main Service 20oA OR LESS - L-05-6:> x- ) 8513 e, s P. 1Zj Main Service 200A TO IOWA NEW CONST. DWELLING pCCLIP• OR ADONS. ( d ACC. BIDS. NEW CONST. MULTI -OUTLET NOWRESID. PERMIT FEE PAID $ cxPOWEERPPPARA S v. SRA $ SHERIFF $ 10 ' OTHER $ $ i I i $ I AMOUNT RECEIVED $ DATE RECEIVED RECEIPT # 400l 11 20.00 1 �— iling Fee 20.00 7.00 23.00 15.00 f 15.00 15.00 15.00 (9?20.00 Tg Fee 20.00 23.00 46.00 So 3.50Fr. @7.50 URES B4L o.FOXED APPLNS. OR OUTLETS ESID. EA 5.00 VEX.00CUp.OUTLETORFW Service 23.00 me Facilities 20.00 Misc. Wirinq 23.00 I PERMIT FEE $ Si'S —1 I MECHANICAL PERMIT Fling Fee 1 20.00 1 I Hood . 1 1 6.50 1 1 PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST. TMPKE TO L FEE $ HAZ D, f1.000 CDFrV6EL W1 HD SSUE � \ This permit Is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By PERMIT EXPIRES ON Date COUNTY OF BUTTE -DEPARTMENT OF DEVd IIYIEPAERVICEKUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: o ASSE SOR PARCEL NUMBER D� ropo ed Building Use: Counter Technician: Date: It ! required in order to apply for a permit. All boxes MUST be checked OR marked NA in prder to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance d sign and supporting documentation in duplicate. 7. Statement of Intent for n sated and A/C for Non -Reside ti Buildings. Ir>Gt1N 8. Manufactured hom , ata sheets and installation in arriage line inf Floor Plan ie down or fnd plans, in duplicate. ❑ 9. 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. D 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chic r 0 fl'Ville, as applicable. ❑ 16. Other Remai ing items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 17. Fire Sprinklers............................................................................................ , 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by t� 0 19. Soils Report and/or Engineered Foundation required ........................................... ❑/ 20. Erosion Control Plan Required........................................................................ ESI 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ A2. City of Chico Plumbing permit ....................... ....s............ ..... ........................... ` (23. California Department of Forestry plan approval �] paid. Sent by: ....... x-0 `24. Planning approval (A) User 1_ (B)Parking: (C) Parcel Check: -"25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number ................................ .... ...- El 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization....................................................... .. . % 33. Recorded copy of Agricultural Acknowledgment Statement ...........................�/ 34. Manufactured home utility clearance............................................................... ❑ 34Exis�violatio andlor expired permits......................................................3estriction........................................3t Deed, M.H. it of F Letter from Legal Owner, ecc to H.C.D. $ 38. Other: ❑ 39. Other: and hold for pickup. When issued Telephone ° I have been informed of the above 'ems and requirements for obtaining a building permit. Applicant. Date:` - 1. Index perfY it application for the above its s numbered: Plan Check Letter 2. Additional items required }� Con I resigner, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: s ' 0 ontractor, designer, own r was advised of the a ove to by, ❑ phone, ❑ mail, ❑ counter, b Date: 41 Plans reviewed by: Date: ( • 0 Plans approved by: YYUDate : ' Structural reviewed by: Date: Structural approvedby Date: Note transfer by: Date: Yellow: Building Division r s E.H. USE ONLY ` • 'Fiat Ran Attechad r Finaa Ran Att�sit, Sam to G.D. 1-6-0 / 1 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance �ev ter- 7-0 AJ AA c• .�-�" .��L. �7'a - 0 o i(o Owner Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well ✓ Clearance for ✓ dwelling. Other Hold final for: Final clearance O.K. for: NOTE: vironmental He 8/96 cialist Date OWNER COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 ' SCHEDULE OF RECEIPT OF FEES v / A.P. #hEff �/ o✓�1 �� 1 3D BUILDING USE DATE 7 RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ l f --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... 2. S OL DISTRICTEt (pa o 1 FEES (pt (fo 3. S FF aid at Buil Residential........... . Units Commercial (sq. ftg.)..... Sq.Ftg. 4. URBAN AREA FEES bl fter - r!. �� v Division) X $360.00 =$ X $0.03 = $ (paid at Building Division) Residential (per unit)..... X = $ # Units _ Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES (� $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Fig. Amt. 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be change during the plan the ng process. APPLICANT DATE Pursuant to Gove ent Code Section 66020, -you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days the date of approval of the projector from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District Building Department No. oo A.P. Number Jurisdiction: city County 0 Property Ownerf —le Property Location/Address Subdivision Lot No. Residential Development No of Living Mobilef Home Units Installation Commercial/Industrial New Addition Building ........................................................................ Sq. Footage Addition/ *Supplemental to (Group R) Conversion Permit # *(No foundation Inspection) ............................................................................................... . .... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage (Including Exterior Roofed Areas) Date District Identification No. School District certifies that (Applicant) (Street'Address) (Phone Number) '41 A 'A /7 /'P A (city) (State) (Zip Code) has complied with the requirements of Resolution No. 0 by payment of $ J'9,;20, �19- representing square feet. 2926 FULL MMGATION School District Representative Date Paid by Check # Remarks: -C-o r 1-71 -a Nota: You may protest Irm Imposition 'of the fen Identified above by submitting a written protest tothe DistriMincompliance with Govaninent Code Section 66020(a), wffldn 90ays from the date fees are paid. Failure to submit a timely written protest vAll'pfohU* you from challeonging; the Imposition of the lass In any court action. N, subsequent to the School District Representativ* signing this Butte County Schools Impact Fee Certification Form, the Seimool Dli I triet In rmslMNd by the applicable Local Planning Agency that t1ft project Isbeing *viewwd under the Calftrida Environments[ Quality Act (CEQA) this me rimay be subject to additional school al fen to fully ~*.Ib Impact on it* school distfkft schools. White (applicant), Yellow (building department), Pink (school district) feefofm.xis (10/03)dmm ARID WHESIRECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 03 -Feb -2004 2004-0006172 Has not been compared with original BUTTE COUNTY RECORDER i i AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL' DEVELOPMENT Section 26-8 of the Butte County Code requires 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: SEE ATTACHED 'LEGAL DESCRIPTION Date �c7 6^' i' PROPERTY O NERS: X }{ colt Worden State of Califorr iia County of Butte On - 451% before m personally appeared ,zz�� personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS y hand and official seal Signatur TERRI.A. RUSTIN APN: 072-610-016 & 018 a Commission X1442021 Notary Public -California rn v Butte County My Comm. Exp. OCT. 24, 2007 DEC-la-EO03Qi4:19 FROM:STPPLES 0816 5305331399 1u:_a38196 EXHIBIT "An OF CALIFORNIA, IS SITUATED IN THE STATE REFERRED TO HEREIN FOLLOWS COUNT �F BDTTE' AND IS DESCRIBED AS E UNINCORPORATED AREA pnR Z' 3, AS EAL PROPERTY SITUATED OF PARCELS 1 AND ALL THAT CERTAIN CAFORNIA, BEING ;A IN THE OFFICE OF THE OF BUTTE COUNTY, RECORDED KAY 24, PARCEL OF CALIFORNIA, ON SHOWN ON THAT CERTAIN 11 AND BEING MORE 67 OF MAPS, AT PAGE(S) RECORDERNOFBOOK CONY OF BUTT 1978 PARTICULAR LY DESCRIBED AS FOLLOWS: COMMENCING AT A 1/2" REBAR SET -FORGE 5HEAST�TMRD�B& M. C PER SAID oID SECTION 24, TOWNSHIP 19 NORTH, RAN 89° 19' !21" WEST, A DISTANCE OF 1314.59 PARCEL MAP; THENCE SOUTH FEET; THENCE SOUTH 00° 27' 33" EAST, A DISTANCE OF 247.20 FEET; THE NORTH INNING?,THENCE�ALONGAET TO THE TDISTANCE 3 HEFOLLOW NG NUMBERED 80.00 ECOURSES: 1) CONTINUING NORTH 890 32' 27";EAST ALONG SAID LINE, A DISTANCE RESERVING THEREFROM.A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES AS SHOWN ON SAID PARCEL (AP, RECORDED IN BOOK 67 OF MAPS, AT PAGE(S) 11. ALSO RESERVING THEREFROM AN EASEMENT FOR WELL AND WATER PIPELINE FACILITIES ON, OVER AND UNDER A STRIP OF LAND 15.00 FEET IN WIDTH LYING 7.50 FEET ON EACH SIDE OF THE EXISTING WELL AND WATER PIPELINE AS LOCATED ON SAID PARCEL 3; THENCE SOUTHEASTERLY ALONG SAID WATER PIPELINE TO' THE SOUTH LINE OF THE ABOVE DESCRIBED PARCEL FOR THE BENEFIT OF THE LAND DESCRIBED IN EXHIBIT "B" ATTACHED, ON THAT CERTAIN CERTIFICATE OF MERGER RECORDED Qy_C. at a003 UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 01003-9-73/) PARCEL HEREIN IS PURSUANT TO A LOT LINE ADJUSTMENT APPROVED BY THE COUNTY �{OF BUTTE, SHOWN AS PARCEL A, IN CERTIFICATE OF MERGER RECORD d U 7 �� SER BUTTE COUNTY RECORDER'S SERIAL PORTION OF APNS 072-610-016-000 AND 072-610-018-000 CONTINUED OF 194.56 FEET; 2) THENCE SOUTH 070 57' 14" EAST, A DISTANCE OF 1174.58 FEET; 3) THENCE SOUTH 000 00' 00" EAST, A DISTANCE OF 350.00 FEET; 4) THENCE NORTH 900 00' 00" WEST, A DISTANCE OF 150.00 FEET; S) THENCE NORTH 560 15' 47" WEST, A DISTANCE OF 242.25 FEET; 6) THENCE NORTH 440 00' 00" WEST, A DISTANCE OF 150.00 FEET; 7) THENCE NORTH 460 00' 00" EAST, A DISTANCE OF 150.00 FEET; 8) THENCE NORTH 000 27' 33" WEST, A DISTANCE OF 1165.12 FEET TO THE POINT OF BEGINNING. RESERVING THEREFROM.A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES AS SHOWN ON SAID PARCEL (AP, RECORDED IN BOOK 67 OF MAPS, AT PAGE(S) 11. ALSO RESERVING THEREFROM AN EASEMENT FOR WELL AND WATER PIPELINE FACILITIES ON, OVER AND UNDER A STRIP OF LAND 15.00 FEET IN WIDTH LYING 7.50 FEET ON EACH SIDE OF THE EXISTING WELL AND WATER PIPELINE AS LOCATED ON SAID PARCEL 3; THENCE SOUTHEASTERLY ALONG SAID WATER PIPELINE TO' THE SOUTH LINE OF THE ABOVE DESCRIBED PARCEL FOR THE BENEFIT OF THE LAND DESCRIBED IN EXHIBIT "B" ATTACHED, ON THAT CERTAIN CERTIFICATE OF MERGER RECORDED Qy_C. at a003 UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 01003-9-73/) PARCEL HEREIN IS PURSUANT TO A LOT LINE ADJUSTMENT APPROVED BY THE COUNTY �{OF BUTTE, SHOWN AS PARCEL A, IN CERTIFICATE OF MERGER RECORD d U 7 �� SER BUTTE COUNTY RECORDER'S SERIAL PORTION OF APNS 072-610-016-000 AND 072-610-018-000 CONTINUED Dk,.-le-20lQ3 14:20 FROM:STAPLES 0816 5305331399 70:3438496 EXHIBIT "A" - CONTINUED PARCEL II: A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 24, 1978, IN.BOOK 67 OF MAPS, AT PAGE(S) 11. 191719.DES SITE PLAN REVIEW APPLICATION Date: AN Permit Number (if applicable) (njt'l. N�Ci44-i 9 • APPLICANTINFORMATION Parcel Size: 4 A �. Owners Name: c-,6 A Owners Address: ,V o . zoX 6-6 Telephone No.: 1-9 9-0 60 Situs Address: C-,*— �- Propose_d Use: Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family • Non-residential ❑ New Commercial ❑ Commercial Addition ❑ Commercial Remodel ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other Septic ❑ Well ❑ Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ Other: NIX Brief Explanation (if necessary): 3 U 1 DW�- DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Sta Use) ❑ Approved IM Conditionally Approved ❑ Resolve Problems Prior to Approval • [ Site Plan Stamped Approved By Date - y._ Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: (� ; • M Snow Load Area: JS vz>• -7"Cc) ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: ) O S' p C_ Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: A — Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Dorso 7 of G • Zoning Code Streets & Highways Fire Prevention Subdivision Map Front �- G Side �- 3 p Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Dorso 7 of G • Applicable Development Fees: Standard Fees Amount Formula • ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 a ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other ------------------------ ------------------------------------------------------------------------------------------------ Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final derenn;nation will be made at the time of the building permit. • Parcel Created By El Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: 0 ❑ Parcel Deemed to .be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements •------------------------------------------------------------------------------------ Page 3 of 5 104 Subdivision Map/Parcel Map: Map Date of Recording: -G— `LH — 7 8 Lot: -13 ❑ Use Permit/Minor Use Permit Permit Number: Book: C21 Page: • Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval• N d JJ C ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Pla• must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. Page 4 of 5 National -Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI Project Title: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs 1 acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or, inaccurate information may result in revocation of grading and/or other permjts or other sanctions provided by law. Signed: Title: Date: re Department County Warner C. Phillips, Assistant Director December 10, 2003 of Public Works o f B u t t e Worden Family Trust P.O. Box 5673 . Oroville, CA 95966 Re: Application for Certificate of Merger AP 072-610-016 & 018 V Dear Mr. & Mrs. Worden: 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 On December 10, 2003, the Department of Public Works made the finding that the Certificate of Merger on the above referenced property is exempt from environmental review, and approved the project subject to the following note(s) to be added, by the engineer, to the Certificate of Merger: - 1. Add the following note to the proposed 39.74 acre parcel: "Well easement for rigrits.of access and maintenance shall.be reserved for the benefit of this parcel." 2. All new structures must meet the Fire Safe Regulations of Butte County and Public Resource Code 4290. The Certificate of Merger cannot be recorded until these notes have been added and the original Certificate of Merger has been submitted to this office. After the recording and processing of your Certificate of Merger by the Butte County Recorder's office; we will return your certificate to you. If the notes have not been added to the certificate within one (1) year from the date of approval by the Department of Public Works, the approval will be considered null and void. This action will be final if an appeal is not filed with the Clerk of the Board of Supervisors within ten (10) days of the date of this letter.. You or any interested person must do so in writing, with the appeal fee of $50.00, to the Clerk of the Board of Supervisors, 25 County Center Drive, Oroville, California .95965, prior to 4:00 p.m., December 22, 2003. . c Worden Family Trust, Merger AP 072-610-016 & 018 December 10, 2003 If there are no appeals, we will submit the Certificate of Merger to the Butte County Recorder's office, for recording. If you have any questions concerning this matter, please contact this office at (530) 53877266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, S uart Edell Manager, Land Development Division SE/kp cc: Environmental Health Department ,/Building Division Reily Smith Michael Evans OPT P(RCH ENVIRONMENTAL HEALTH JAN p52 11Z' AI UNTYCENTER RIVE APPROM T x- VED /0f'l • APPR V "'Utto Couniv LEn !ro mental ea',lh ignature DIVISIONS ■ I c IRu w am LAY sZ r7Dc vAi ssa or k Rp un m w D I 53e `4.}`�-� I-f439-3FlK-ZB-WtRt D]IITX BY: 11 I TDM Zoxm 1$1. VATZ0117Dr8@ ]root SONV SlIX SMT 1 OF DWgFG NUMBER 4820-Ct