HomeMy WebLinkAbout079-100-03601,7CI- l00- 03�
�3G.699.93fr 04-3563
KDOGLOMA VISTA DR, OROVILLE
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WNER
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Butte County Department of Development Services AUT TF
a
YVONNE CHRISTOPHER, DIRECTOR c o
o 0
7 County Center Drive o-- _� - o
Oroville, CA 95965 0 0
6 (530),538-7601 Telephone
(530) 538-7785 Facsimile
LO
TO: WILLDAN
FROM: Scott Rutherford (530) 538-7160
' srutherford@.buttecounty.net
1
SUBJECT: Plans Transmittal For Review Per. Contract
DATE: 12/2012004;
Applicant: Khan,Doug Permit 04-3563
Project Type: NSF/Gar/Gov APN: °'036=60.0=036.
100% 70%
Plan Check Fees $ 1,141.60 $ 799.12
$ 1,141.60 $ 799.12
W I LLDAN Fee $ 799.12
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP043563
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS 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
Issued Date: 09/23/2005 APN: 036-600-036-000
the Business and Professions Code, and my license is in full force and
effect.
License Class license Number:
:
Site Address: 155 LOMA VISTA DR ORO
Map Index:
Date: Contractor:
Description: NSF (2000) GAR (768) COV (42)
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: KHAN DOUG S & ELINORE
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
875 S BARRETT RD
signed statement that he or she is licensed pursuant to the provisions of
YUBA CITY, CA
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
95991-6138
she is exempt therefrom and the basis for the alleged exemption. Any
(530)674-2153
violation of Section 7031.5 by any applicant for a permit subjects the
bobbakazoo@sbcglobal.net
applicant to a civil penalty of not more than five hundred dollars (8500).):
33' 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 (Sec. 7044, Business and Professions
Applicant: KHAN DOUG S & ELINORE
Code: The Contractors' State License Law does not apply to an
$75 S BARRETT RD
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
YUBA CITY, CA
provided that such improvements are not intended or offered for
95991-6138
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
(530)674-2153
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
Contractor:
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of t usines Professions Code
9 23-0 Owner:
Date:
License #:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Cl I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
Architect:
is issued.
Engineer: ANDERSON ENGINEERING CONSULTANTS
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 2810 S.F.
Policy #:
Valuation: $149,104.00
❑ I certify that in the performance of the work for which this permit is
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the workers' 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 those provisions.
l� LII
cJ, o4ge
Date:
INloG
Applicant:
U
12 / 17
WARNING: Failure to secure workers' compensation coverage is
it 1
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars (8100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions to do work indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
OJ _ n
0 r1
Name:
_
By: ,I1itrn� ` �, 1 /
nI� ^D/ate:
Address:
PERMIT EXPIRES ON: l=l \�
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction..I acknowledge it is unlawful to alter the substance of an i ial form or dgcument of Butte County. I hereby
authorize representatives of Butte County upon the above mentioned property for inspection purposes.
�to/enter
)0()6 ILS/'/6�✓
PrintName:9 Signature:
" 23- vl
Date: /
i Owner ❑ Contractor EllAgent for Owner EIAgent for Contractor
B. C. Building Permit 01-16-04 pg 1
f[�. 00
4'::w
B TTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES (I� I.60
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
�g9•
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER
Last Namet/
/7
irst Narne
Address
97 i 5 1, //# E
City yU C
State
Zip
Phone 6' 7 y - z /;--?
Fax
E-mail ,96,66IM&—w !tT SBC &(-MA,.�F �—
ARCHITECT/ENGINEER
CONTRACTOR
Name
ALL
Address
"p9 %ZZ-
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
Lic. #
Class
ARCHITECT/ENGINEER
Name
Address j6 % a K&0- Rd s0 -ft h
City IV F,val1 V A� M
State
"p9 %ZZ-
Phone3a _ �7�, ���
Fax
E-mail
State. License Njnber
ysyj
APPLICANT NAME
Name O AVN E/L
Address
City
State
Zp
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For office use o y:
Zoning
Property Address
1S' L 0 M U/i
Flood Zone
Cross Street, ,
Xs�
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
64-,353
BP
LOCATION
AP#
036- Goo - 036
Property Address
1S' L 0 M U/i
Ci
o1�o�i%/r✓
Cross Street, ,
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
.Description or Scope of Work:
N ti w slx06 Le r-19 I twFLU,)C
Sq. Footage 2 000 S ft C/Ift, ?E6 Pt
❑ Structure Built without Permits co u I 4 L s
❑ Proposed Change of Occupancy
(Note previous use):
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
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: ✓ Bldg
6 l, SRA
Receipt. �` e <) —� Sheriff
R90
�
�j SMIP
6 Other
Datep/ 5�5 rG
Q Total
Page 1 of 2
REV 7-27-04
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 /N 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. (Note: Not required for additions to
mobile or modular homes.)
❑
5.
Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑
6.
Manufactured homes: (A) Data sheets and installation inst, (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.
Detached Accessory Building Form filled out by the owner (if required).
❑
12.
Hazardous Material Form (for Commercial Buildings only).
❑
13.
Sanitation and site plan approval from the Environmental Health Department.
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.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application 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 7-27-04
. .• r. - ( ✓ •'�"�' - � r .....j...- ��'^ +"Y+�-nsti�`.. ��^�Y.��^+� � r�J.�`..1�: /'Y.:'�N� .. C"_..1' r ..�' ... �-`� i ti...
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: ASSESSOR PARCEL NUMBER ' `�"'�' ' GJ2
6
Proposed Building Use: Counter Technician: Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order t pply.
�p 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.
5' 4. Engineered truss details and layouts in duplicate. No faxes!
5. Letter from Engineer or Architect for truss design review.
g' 6. Energy compliance design. and supporting documentation in duplicate.
[j 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all 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.
❑ 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
❑ Hazardous Material Form _
15 Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
❑ 6. Other Cs_")
Remaining 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 _
❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........
❑ / 2Q. Erosion Control Plan Required........................................................................ ........
QoW21. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ 22. City of Chico Plumbing permit ............................................ :....
23. California Department of Forestry plan approval ❑ paid. Sent .............
24. Planning approval (A) Use: 09�(B)Parking: (C) Parcel Chec . aC D
❑ 25. Contact Land Development about _ Improvements, _ Drainage .........................
5�2LNPDES Form.............................................................................................
(X. 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 ..........................................
31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
0 3 Letter of Signature authorization....................................................................
ga* Recorded copy of Agricultural Acknowledgment Statement ................................. .
❑ 34. Manufactured home utility clearance............................................................... _
❑ 35. Existing violations and/or expired permits.........................................................
❑ 36. Deed Restriction.........................................................................................
E)37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 38. Other:
❑ 39. Other:
When issued Telephone I-i'� and hold for pickup.
I have been informeof the above items and requirements for obtaining a building permit.
Applicant: Date: %Z '/7 "Uig
1. Index permit application for the above items numbered: Plan Check Letter
2. Additional items requ'
Contractor, designer owne ' as advised of the above data by phone, ❑mail, ❑ counter, b Date:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date:OS
Yellow: Building Division
utte County Department of Development Services
)NNE CHRISTOPHER, DIRECTOR
WILLDAN
Scott Rutherford
(530) 538-7160
o�UTTFo
0 0
0 0
c�U N'�y
srutherford cDbuttecounty.net
Plans Transmittal For Review Per. Contract
12/20/2004
Applicant: lKhan,Doug Permit 04-3563
Project Type: NSF/Gar/Cov APN: 036-600-036
100% 70%
Plan Check Fees $ 1,141.60 $ 799.12
$ 1,141.60 $ 799.12
WILLDAN Fee $ 799.12
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538.7785 Facsimile
Ln
M
TO:
'
FROM:
411-
1
SUBJECT:
CD
im _
DATE:
WILLDAN
Scott Rutherford
(530) 538-7160
o�UTTFo
0 0
0 0
c�U N'�y
srutherford cDbuttecounty.net
Plans Transmittal For Review Per. Contract
12/20/2004
Applicant: lKhan,Doug Permit 04-3563
Project Type: NSF/Gar/Cov APN: 036-600-036
100% 70%
Plan Check Fees $ 1,141.60 $ 799.12
$ 1,141.60 $ 799.12
WILLDAN Fee $ 799.12
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
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
OWNER A.P. # ' l�'OZit ,0J
• 1 /
PROPROSED BUILDING USE �j DATE
RECEIPT # DATE REC.
1. BUILDING PERMIT FEES
--- Balance Due ..................... $
---Additional Fees Due........... $
-- Revised Plan Checking Fee.... $
2. SCHOOL DISTRICT FEES 1 y Y 1 �'ot�d 9/23/05
(paid at School District Office) (form available after Plan Check)
3. SHERIFF FEES (paid at Building Division)
Residential............ X $360.00 =$ _
Units
Commercial (sq. ftg.)..... X $0.03 = $ _
Sq.Ftg.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit)..... X
# Units Amt.
Commercial (Sq. Ftg.).... X
Sq. Ftg. 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'
$paid at Building Division)
8. WATER TENDER FEES BATTALION # y
$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. Ftg. 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 changed durin&A4gplan checking process.
APPLICANT
DATE IZ12-dl
Pursuant to Government 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 from the date of approval of the project or 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)
ENCROACHMENT PERMIT
County of Butte Department of Public Works '
7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356
Download Forms: www.buttecounty.net/publicworks/forms.html
NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE
Phone (530) 538-7157 Ext. 2016
Permit Number
District
APPLICATION
I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads
and highways, all in accordance with Coun ordinances and general laws. All information except signature must be typed or legibly rinted.
1. Applicant's Name: 0 6 u�
r /,
la. Company Name:
2. Address:
�c 16711 67q
3. Phone:
1/J
4. Asse�arcNber
�03b
'
5. Location of Work to be Done
V
6. Applicant's Signature 7. Date: �j- �j. D,
CONTRACTOR'S INFORMATION
8. Contractor's Name
l� del
9. Address
, CJ �jO J e U,ie� �/� /�
! v� / t/ &
10. Phone
o &7 -
11. Fax: S 30
12. Contractor's ricense Number:'/
`i
13. Certificate of Insurance:
Ye No: ❑
14. Contractor's Signature: � �G
14a. Date Signed: _ -D�
15. Authorized Agent:
TYPE OF WORK TO BE DONE
16. Please Check:
Curb: 1:1 Gutter: 1:1 Sidewalk: ❑
17. If Driveway List Type:
I S. Other Work - Describe:
19. Plans Attached:
❑ Yes ❑ No
PERMIT GRANTED
In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below,
permission is hereby ranted.
20. Conditions :s -:31
h \
r� �iu • %� ° 64�,- • . !►� r�,,1� i i
te�aa,, rvk Ak :JL. 1
Underground Service Alert U.S.A. must be notified two working days prior to any excavation. 800-227-2600
21. ❑ All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions ❑
22. Date Issued
23. Expiration Date: Q, / O
24. Surety: -7 O r
25. Date Paid:0�
26. nt Paid:
27. Paid By: atr w-..
28. Receipt No.:
Mike Crump, Director of Public Works
By:
For County
29. Final Inspection Date:
30. Inspected By:
❑ Completed - OK ❑ Completed - Not OK
❑ Additional Comments Attached
Use only:
31. Comments:
Note: If permits are faxed to any number besides (530) 538-4356, they can be delayed up to one weeK.
Page I of 2
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—�.,,l. .t.-`�•--fin'-.. _ "..✓l. �"r'1r-.--....,,..F.. �Fr4•w-••-'ti.-.. �`•'vv:' h. .. - 'a...vh"r
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District V I Ce Building Department No. 435�o
A.P. Number 00-6),66-03(C7 Jurisdiction: City ®County
Property Owner
Property}LocationlA
Subdivision Lot No. s
X............ _........ ......................... ............._........................
Residential Development ® Q Q Q Sq• Footage
No of Living Mobile Home Addition/ 'Supplemental to ' (Group R)
Units Installation 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
Commercial/Industrial Q Q
District Identification No. D
\ \ e kks: tom. School District certifies that
(Applicant)
(Street Address)'' '
,(Phone Number)
oy-a g 5 a �o 1�0
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.
representing at) 60 square feet.
School
J
i
by payment of $ 44efb
2926 $ r
FULL MMGATION _
1'017—* 5
Date
Paid by Check # Remarks: 07 .►(„ mn 10 3 40
ZIoon
Notlee: You map protest the imposition of the fan idsnttfled above by submitting a written protest to the District, In compliance with
Govemmerd Cods Section GN20(a), within 90 days from the date Mss aro paid. Failure to submit a timely written protest wlll'prohibit
you from challenging the Imposition of the fess In any court aetlom
If, subsequent to the School District Representative signing this Butte County Schools Impact Fes Certification Form, the School District Is
WR by the applicable Local Planning Ager ey"this project Is being mvlawsd under the California Environmental nudity Act (CEGA)
this project may be subject to additional school fess to fully mitigate. Its Impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.x)s (10/03)dmm
' s
,
PERMIT NO.: 60-05
Lake Or`oville Area Public Utility . District
1960 Elgin Street
OROVILLE, CALIFORNIA 95966
533-2000
DISTRICT APPROVAL AND
VERIFICATION OF INSPECTION
BUILDING SEWERS
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 by Butte County of a Building or an Occupancy Permit, 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:
Applicant Phone No.:
Property Locations(s):
A. P. No.(s):
Fees due:
WKXXX June 8, 2005
Doug Khan (:owner -Builder)_.
875 Barrett Rd
Yuba City, CA 95991
(;530) 674-2153
155 Loma Vista Drive
Conley Acres, Sub 30
036-600-036
Paid $4207.38,. includes Connection Fee $650.00, SC -OR
RFC Chg $1277.00, Capacity Chg $1690.00, Coply Acres Short
Line Extension $590.38
Application for service approved:
OROVILLE AREA
PUBLIC UTILITY DISTRICT
Inspection(s) made and successful test(s) observed:
Location:
0
Lake Oroville Area Public Utility District release to close permit:
Date: By:
Date:
CONNECTION PERMIT
APPLICATION FOR SEWER CONNECTION AND SERVICE FROM
LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT
I )0� + hereinafter referred to as "Applicant",
being the protefty owner or owner's agent desiring sewer service, hereby requests Lake Oroville Area Public Utility
District, hereinafter referred to as "District", to connect Applicant's sewage disposal line to District's sanitary sewer
system and to provide sewerage service.
Location of property'. Y� L lS"t t � 1) r A.P.#: �c
Subdivision: C_a'c.S St_:;hj<J Lot#:_Block#:
Property Annexed
❑ Property Not Annexed
❑ Property Annexation in Progress
Kind of Service:
11
Residential
Residence of Owner
Rental (single family)
❑ Rental (duplex)
Industrial
Commercial
No. of E.D.U.'s this permit:
1
Multiplication Factor:
� o ip �S+)o r t- L1 rlr'-
M o m t h 1 y GhS:
Capacity Fee:
Connection Fee:
LD—
❑ Apartment SC -OR Facility Charge:
Site plan reviewed ❑ Jobsite reviewed
Remarks: C C >
Total Amount Payable This Permit: 3%S
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 Applicant
Mailing Address of Applicant
Phone # of Applicant:
���._
Name of Owner if not Applicant
S;'l�5
Mailing Address of Owner cl c�cl cti l l �j,
Phone # of Owner: S•3
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.
3. Applicant shall secure permit(s) as necessary from the County of Butte prior to doing any work,
including encroachment permits when work is within county right of way.
4. Installation of the subject sewer line shall be at the sole cost and expense of Applicant.
5. Actual connection of the subject sewer service line to District's sewer mainline shall be accomplished by
District staff.
6. All work shall be inspected and approved -by District ~
7. 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.
8. District verification form must be issued with this permit.
Payment of Fees/Charges required prior to final LAKE OROVILLE AREA P.U.D.
inspection. Payment received by: C� 4'
Date: C_C�� �� C)_f Receipt# t,1� 1-13 B
❑ CASH (CHECK #___ Date: L
$ Permit #: U U r C J
`Monthly charge payable at the current rate at time,of-connection.
h
O
+:g.lv.�.��a2�z...�x_._ga.aFiYC
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary
delay in processing and -issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and material for construction of this proposed
property improvement: YES [ k ] NO [ ].
2. I HAVE LX ] HAVE NOT [ J 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:
NAME: _
ADDRESS:
PHONE:
CONTRACTOR'S 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:
NAME: _
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
5. 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
SIGNED:
PROPERTY OWNER:
DATE: /Z-17-0
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
Rev'd 11/4/2004
Butte County Department of Development Services
ADMINISTRATION' BUILDING' GIS ` PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538.7541 Telephone
(530) 538-2140 Facsimile
�v.�'�..Tia�LTL .��,�. < {.x..—�.w�.�..'ti � �.r+�t:�ir��1��'•�.�.�, •y,LL.�.Lal..
Dear Property Owner:
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 your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o 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.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o 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 perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors 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 in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
XV -__1
C. Vieiri C.B.O.
, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
,? W,rMaNT
9 6VTrF
Im:
1 0
o '
0 Department of Public Works
-° C o u n t y o f B u t t e
O
C J. Michael Crump, Director LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
A `r 5 Oroville. CA 95965
(530) 538-7266
(FAX) 538-7171
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 Description: Ot Ld 54a 6 LCAj /j���y � I,rJE Uj,; 6
Project Location and/or Parcel Number: 0,36- 6 4v -0,?�
By signing below, I, the project owner/owner's 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 build -outs 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 Control 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 a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:
Title: DCcJ.r�i�%Z
Date:
Less than I Acre NPDES & SWPPP Compliance Certification
Butte County Storrs Water Management Program
Revised 5/24/04
W I LLDAN K 117 Street
Marysville, California 95901
Serving Public Agencies 530/749.2373 fax 530/749.2199
www.willdan.com
February 2, 2005
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
(530) 538-7169
(530) 538-2140 FAX
SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL
Willdan Project No: 14353-1292
Jurisdiction Job No: 04-3563
Assessor's Parcel No: 036-600-036
Description: Khan's New Single Family Dwelling
Dear Mr. Rutherford:
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and
documents provided for this review that have been found in compliance with the applicable codes are:
* Plans: Two (2) copies sheets 1 through 8 not dated, by Sroka's Design and Drafting.
* Structural Calculations: Two (2) copies dated 03-01-04,by Anderson Engineering -Carl
Anderson P.E.
* Enerey Calculations: Two (2) copies dated 02-25-04, by Michael Sroka.
* Truss Calculations: Two (2) copies dated 02-26-04, by Homewood Truss -Larry Messamer
P.E.
The plans have been stamped with the Willdan approval stamp and dated the date of this letter.
On the pages to follow is the identification of the codes and standards applicable to the project, a code
analysis, conditions -of -approval and identification of any deferred submittals.
/ V V I LLD/ \1 �1 Ma Street
Marysville, California 95901
Serving Public Agencies 530/749.2373 fax 530/749.2199
www.willdan'.com
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24:
• Part 2, known as the California Building Code and abbreviated herein as "CBC"
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC"
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC"
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC"
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS"
CODE ANALYSIS
Type of
Occupancy
Type of
Construction
Sprinklers
Stories
1" Floor
Sq Ft
2 "d Floor
Sq Ft
Total Sq Ft
R-3
V -N
No
1
2000
NA
2000
U-1
V -N
No
1
768
NA
768
R-3 (Covered
Porch)
V -N
No
1
42
NA
42
CONDITIONS OF APPROVAL
1. Approval is contingent upon the review, requirements and approval of other departments
and/or agencies that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals noted at this time.
SPECIAL INSPECTION NEEDS
Our plan review reveals no special inspection needs pursuant to CBC 1701.
Sincerely, '
Isaac Kuster Ricardo Guzman,sP.E.
Plans Examiner Plan Check Engineer
Cc: Alice Mefford, E-mail: amefford@buttecounty.net
Doug Khan, 875 South Barrett Road, Yuba City, CA 95991, Email:bobbakazoo@sbcglobal.net
Page 2 of 2 County of Butte Perini.t N unifier 04-3 563
_
Wi[ldan 1?.rc�jcctlNurn. b .r 14 �5;-1292
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
2005-0057790
Recorded i IREC 1=EE 140.iA
Official records i
County of i COPIES 2.50
But ie i
CANDACE J. 61RliBBS' i
County Clerk—Recorder!
i
�A
011!E&N! 23 -Sep -2005- i Pane i of c
IIII lil III 1 IIII I II II lilill 11116111
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:
Datey .: /0 O J
State of California
County of S(/iTF&Z
/4 1i) X6/1 to
PROPERTY OWNERS:
7 LCI -4
On _I(�'=' 1U�1>��_�� before in
personally appeared ,�,r,ia V—keLK &-c,4 �. I i Aare— 4j ,K- personally
known to me (or proved to me"on the basis of satisfactory evidence) to be the person(s) whose name(s),W/are subscribed
to the within instrument and acknowledged to me that heshe/they executed the same in hWher/their authorized
capacity(ies), and that by his4w/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 nd and official eal
r
Signature '� Seal: DUANE F. HALEY Z
CORAM.*1425735
>I*'
OT/A,R,UNTY M
S,, PUBUUTTER COyCALI OANiA
A.P. # "7 Can. Eon JUN 29, 2
Order No. 00211663-001
EXHIBIT A
THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS:
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, DESCRIBED AS FOLLOWS:
LOT 8, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "COPLEY ACRES SUBDIVISION",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE. COUNTY OF
BUTTE, STATE OF CALIFORNIA, ON AUGUST 1, 1963, IN BOOK 30 OF MAPS, AT PAGE(S)38,39
AND 40.
AP NO. 036-600-036
SITE PLAN REVIEW APPLICATION
Date: 1052 Z, I zez AP# 310 '/�X _03
Permit Number (if applicable) C% �' 3� 3
APPLICANT INFORMATION Parcel Size: Wo Q S
Owners Name:
Owners Address:
Telephone No.:
Situs Address: (/[
Proposed Use:
Residential
10 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-':. J,
❑ Multi -family
Non-residential
❑ New Commercial _.
❑ Commercial Addition ❑ Commercial Remodel
❑ New Industrial E
❑ Industrial Addition - ❑ Industrial Remodel
Other
❑ Septic ❑ - Well
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SER DICES INFORMATION (For Staff Use)
10 Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
Site Plan Stamped Approved
By Date
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY ;
Parcel Is In:
❑ Snow Load Area:
❑ 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 requiredb4)
10 SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
• Flood Zone:
• Flood Panel No.: AW, *7C49gsD Index Date: 0-0
❑ 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 EncroachmentPermit
=--•- --- r=
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning:
- --_Gp_ L
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
Side
�- r
30 `
Side Street
Rear
S1
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
C4, Applicable Development Fees:
Standard Fees Amount Formula
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ 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 determination will be made at the time of
the building permit. - : ....�... - ...
Parcel Created By J -I.,
[1 Deeds: - - -
Date of Creation: Legal Access Provided:
-Deed of Reference: Legal Access Required
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:[—] No ❑ Yes
Comments:
❑ No ❑ Yes
❑ No - ❑"Yes
❑ 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
IN Subdivision Map/Parcel Map:
Map Date of Recording: / 3
Lot:
❑ Use Permit/Minor Use Permit
Permit Number:
Book: ' 3a
Date of Approval:
Page �� L/0
Parcel Map/Subdivision Map/Use Permit Conditions
❑ Comply with the following Conditions of Approval:
❑ 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 Plan
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 roa
EJ
0
Page 4 of 5
#,
7
I -
Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
CALarrys\Building Permit Site Plan Reviewl.doc
Page 5 of 5
! E.G. O]°LEY o single man, a9 owner of Me land (ncb d SWIM
QOPLEY sILYb<S SL@O�Sk7N, ere saorr'n m My avxmd MVP, and aur7E CaNrr
r1rLE COMPANY, o cawmiian, as 7iratee wroer oDeed of rias/ dyed Miry 7,
1953 0w 1vcanded Juno 10 4953 h Bast of B✓Me Gowdy 011rabf Awv1 b at
Page . ob hereby certify Mal we are MB &* pffww phase cons" is reaessay
to pass obor /Me to soil bad and wm CaZefe m tre pTpWot07 and vwmW/m of
said mao as sham w hV7 Me edacd dater Nes Nb offer for ded aVhion krpblr
use to, County ~ Pwposes LANA WSrA OR/YE HEATHER aRCLE A11 NA
0RICLEand /hei.ROSE 5$iV ykap C luv WeaE �as sham on the
oaewd rW We Oso offer for dvioabon for public cue, and do hereby obdMe
for sp gdCx pwposes, the following:
(o1 R##1 of way and easeneMp Ar mb; gas, sews, and *wMv ava,
ono /or overhead and wdapawd wigs Aa ekeft a=nd hlaphce service mgoVer
w%M any and o7 awwfenanlces ggaermhniuq Mavm, m, per and Tonder Morse slr*$
of land orng between the rear and /or sf?1 //nes td kVs mai hk /fines oes/peted
Fmic U7K/rY EAwww L/AYE.
(b) Easement for /yM and Or ora Mase ships oflad /yhg between Ne
A071 ad/a .skk Gus of bh ad the Alas sham M-ewn owl dwlavW"SE7BALY!
LINE, sad ships to be kep open and five of AwNivc
(c) Ease eV for guy &odes ad onchoroges extending 20 feet Am be
center- lines ofeosemerds refereed to h (a) above and five feet in with, of five
booNan, sown hereon by symbonk
J
BUr7E ca NrY r/TLE Ca~y,
o corporation
By N e at
SrAIE Or C41LF0914il /ss
owwrY oF BUrrE 1 .
07 Mis,21"day of J Ag 1963, before me Borvvro P.N .r rrr
o AtAvy AWIC h and for the County of Butte persmd/y agwaed E G.
COPLEY dam=n to me to be he palm Mase now d subscribed m the faegoiV
:. awrrWM and ocknaw¢dged to ere not he awcufN the 55x1.
.'�• fTxy • fJ / JJ/Y
� rev
f?�i'4•' . My c0mmwi 7 expves
(,
57A7E O' C9L1Fg9Y/AJu
COUNTY LF hur7E 1
On fta= dw diT'!U . Nw,, belbre me; J-.✓Y9/,�R �ANrr<P
o Notary firb/ic h and for the Oxxnty of Butte pwwv* awex& WL LL®VTANA
bwrm to me to be Vice Resetnf a, BUr7E c&iL TY 77TLE CANH7NY o cowalo{
wficA executed ihe fawang arfirmole oral Is k x m b me to be the per= who
execded Me cwhftoh on behaf of rte SUrrE 00t NTY r/7LE CONFANYnyrW
derecn, Ord 00bna0eogad to ml /ho/ Said COpora on exeaded the Some.
Pu /
rs_ MY comm/35/0) Cy reg chi'/
.7F
/, FH. SEELY ✓R., AUD/7DR of Me CLLNrY OF d'/rrE Stec of
Cd*nbb ob hereby certify Mot Mae ore no lax hens ogabst COPLEY AcArS
S/BDAI&TV os /erv(n set /orth, or wpe%d &We, Canty,
Akn%aipo/, or Lad Aces, of spam/ assessment cd/echd as Rua, except
loxes a special smafs AO et poyab,� 7dxes a acre sments ns' ! ar
a hien kN I., yete65Gjafa 11 / estimate m be h Me amovrd o1 p _
F.N.'A y'JR' .JyA
WA rt'R B. CANES, do hereby arfiy thatIIr. a Regirtered CWl
Feuer of Me Sate Of COihvnlo, Mat the meexed.M ,� Y cLEY ACRES
A4901VIS/ON cmrechy mprvsawl 1; )map wdr my
srpervalm h May, 1963, that it 41 hct ocd clap . ol Mmorxeeofs
sta m thereon exist widae dea e oho or. pss/Ai»s ibwn and
ore .v/fideM m anb/e Me "vey m be retrda
WAL7ER17 6RAIES
Regatered C" Eryh wr Aft 7294
/, WF CHAN, DIRECTOR OF PLAANNG of Me PLANNING
CANN/SSW O- THE WVNTY Or&97E, S»de d ca/%mmn, ob fr0' * arl%fy
Ihd the mneuM 4hol awp of OOiLEYAogrS-g43aV/SVN OXAMM
2&t0ntco//y wiM MegbAmfn oesV7 shown m ft fmmh're mop Mich was
gp'aved by MIs cim wson anAprd 10 /963. '
WF CHAN
Director of Planning
R. P. O'NEXL, DIRECTOR OF PABL/C WORKS of the CahVrYX
BurrE, Sate cfCeManio, do hereby cagy !lel /hare exammed the IFr& Mop
Of COFL EY' ACRES SUBDIVISION that it B substantially him
.lame as oWeared on the renmtive Mop on Re and any Oppmred &Y&UN01)
Maeof, Md a// the /aowslau of the StWAI S,VN A(APAGr of Me Statutes of
Cd%farnla and any local Ordinances app/cable d ft time of q Vmva/dsad
redoh've Nop hae teen compd'd Win and/ am mf%sted Mer Me map atec/nataly
correct.
?
.P. 24, O'notr of lid/.c Ntrks
Count' of Butte R.C.E. N2'606
fo —
/ ab hereby calify that m /he 30 xc Ooy of � hY
BurrE CQ.NTY BOARD LF nF1D'7lxSARS' atrraial/y o(YrareI w Map of
OCFLEY ACRES SUBDIM011, / 7711 reoelp of 16**lay sera!,
n Me Audit=s esl/mafid anawd d� ro hwre payment of AM xACYr '
me o /len, but AW.W POVAbJas wa?bmrkdXd. LANA VISTA ORNE HEATHER
aRCLE, AAI"A O'RCLE rA/IPHILL ORNE, MO/7REL CIRCLE, Dd'RWOOD
DRIVE, :-H4/N'rEROR/✓E, and MEG.RDt DeVE as .drown on Sala n4. &W deed
lr ObOMtOn for At& use were pa'eP!'ad ce bdWf'd Iter public Ace ownty racdpwp sm
`iatLif;� rC'
Cou?N C/er ; n�� by Deprly
Reardeddn the Orme of Me RECORDER OF Vr7E GafvrY, Slate of
COAZO-10, at Me request ofB'GTTkoPt/e rte M%sL'day of 69
d oravb , -6' a'claaf P, Al., in Mop soot -_3 -- blpogw_jp
Serio/ Na _7 -TR;r .
aC.�GOLr/! d/! �-C2L6G0
Canty Recorder
COPLEY ACRES SUBDIVISION
A PORTION OF THE EAST HALF OF SECTION 22,
T.19 N., R.4 E., M.D.B.SM.
OROVILLE, BUTTE COUNTY, CALIFORNIA
OWNER 8 SUBDIVIDER
E. G. COPLEY
SCALE Pd00'
ENGINEERING OFFICE OF
WALTER a GRIMES R.GE. 7294
1338 MANGROVE (NE. CHICO,CALIF'ORNIA
JUNE 1963
PON RPE AT AVRiwABT cavo? QF SEcrtav 22
..09919
99.15
99.19
60!0
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COPLEY ACRES
SUBDIVISION
16 A PORTION OF THEEAST HALF OF SECTION 22,
____ T.19N., R.4 E.,M.D.B.ak .
OROVILLE, BUTTE COUNTY, CALIFORNIA.
OWNER B1 SUBDIVIDER
E. G. COPLEY
SCALE 1%100' ,TUNE 1963
ENGINEERING OFFICE OF
WALTER 8. GRIMES RCE. 7294
1338 MANGROVE AVE., CHIOO,CALIFORJIA.
SHEET 3 OF 3 SHEETS
,p7—y'o
7
L•
AND WHEN RECO21DED 4 I TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
2005®0057790
Recorded I REC FEE 10.00
Official yyRecords I
CoButteof i COPIES 2.50
CWCE J. GRUBBS I
County Clerk-Recorderl
I
I SA
011:20AM 23-Sep-j+M I Page 1 of
rr 2
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:
� t � L �-XH/ a/ / n to
Date �-/0-0
State of California_ _
County of !.Svc /LF
PROPERTY OWNERS:
Q
.cSL Gll"
On ID1'-6'.JUne- before
personally appeared 5:�,n A Q S. V—ku_c1 a -K4 G— I :.1or�--- 4elP-v%- personally
known to me (or proved to melon the basis of satisfactory evidence) to be the person(s) whose name(s).W/are subscribed
to the within instrument and acknowledged to me that befshe/they executed the same in hisAlmr/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 ftnd and officialseal
Signature Seal:�N . • DUANE F. HALEY Z
(r COMM. # 1425735
�� OTARYPUSUC-CAUFORNM
' + C.� Z BUTTER COUNTY
A. P. # lJ 10conn. � My Cpmi. Fires AN 21, 200T
2
Order No. 00211663-001
1
A- l' ..
EXHIBIT A
THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS:
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, DESCRIBED AS FOLLOWS:
LOT 8, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "COPLEY ACRES SUBDIVISION",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE. COUNTY OF
BUTTE, STATE OF CALIFORNIA, ON AUGUST 1, 1963, IN BOOK 30 OF MAPS, AT PAGE(S) 38,39
AND 40.
AP NO. 036-600-036