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l � r SITE PLAN REVIEW 4 013.3803 SITE PLAN REVIEW APPLICATION Date: cDc:>7A� JPO AP # Op a) \Z O� 0'7 Permit Number (if applicable) Bin Number APPLICANTINFORMATION Parcel Size: iolo-L Owners Name: Owners Address: Telephone No.: (534) U 2 " (9G 70 Site Address: Proposed 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 ❑ New Industrial ❑ Industrial Addition I er , Septic Agricultural Exempt Building ❑, Other: Brief Explanation/Issue: 0 Commercial Remodel • ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form Zone: �i 7 GP: DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approv ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ❑ Resolved J By Date �vV®ro 1 2006 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Williamson Act Minimum Acreage: F-1Residencecan be built per contract ❑ Watershed Protection Overlay Zone ® SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: • Flood Zone: • Flood Panel No.: 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 ❑ Chapman/Mulberry ❑ Cohasset Area Use Requires: ❑ Use Permit ❑ Variance ❑ Agricultural Worker Affidavit ❑ Administrative Permit ❑ Minor Use Permit ❑ Minor Variance Zoning: Applicable Building Setbacks: General Plan: A ' IZ ❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 2006 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear 54 Height Waterway N/A N/A N/A ❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 2006 Parcel Created By: II 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: ❑ 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 ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Subdivision MV2arcel Map: Map Date of Recording: JUCY G l 71 Lot: Book: 73 Page: 37 3 2006 ow SITE PLAN ..... 7 ..... 7 ...... 7 ..... 7 ..... ...... 7--7 ..... ...... 7 .. .....M`"..........».....:....._ ... ..... ...... ..... . ............ ...... ...... ..... ............. ..... . ..... 7 ............. ............. ...... ...... ...... ...... ...... ...... ...... : ..... ...... ...... ...... ----------- ----- - ........ ...... ....... ...... ...... ............ ...... ............. ...... ...... ............. ..... . ..... ...... ..... ..... ...... ............ ...... ..... . ..... ...... ..... . ..... ...... ..... ............ ..... . ..... ..... ......... ..... . ..... . ..... ...... ..... ...... ...... .... ....... ...... :1 . . . ..... ...... :1 .. 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