HomeMy WebLinkAboutADM20-0065 ApplicationButte County Department of Development Services FORM NO PERMIT CENTER
7 County Center Drive, Oroville, CA 95965 Main Phone 530.552.3700 Fax 530.538.7785 PLA-30
TEMPORARY HOUSING
(INSIDE OF THE CAMP FIRE PERIMETER) ADMINISTRATIVE PERMIT
APPLICANT INFORMATION PHONE NUMBER
MAILING ADDRESS
PROPERTY OWNER (if different from the applicant)
i TYPE OF PERMITTED WATER SYSTEM? I �L D SHARED WELL D SPRING D OTHER----PROPOSED POWER SOURCE? I PERMITTED ON-SITE SEPTIC SYSTEM?
� D GENERATOR D SOLAR D BATTERY D OTHER-----I � NO
APPLICANT'S ACKNOWLEDGEMENT I certify that all of the information submitted is true and correct to the best of my knowledge. I have read and acknowledge the permit requirements as set forth below (page 2) and agree to comply with them. l further understand that should the proposed improvements be modified or if the use expands beyond the requirements of this permit, that I will notify the county to obtain any necessary approvals.
APPLICANT'S SJG�
I ZONE DISTRICT I EH CLEARANCE PUBLIC WORKS CLEARANCE
0 YES D NO D N/ A
APPLICATION REVIEWER
PROJECT NUMBER
ADM _____ --------
I O YES ONO ON/A
BUILDING PERMIT REQUIRED?
0 YES ONO ON/A
i BUILDING PERMIT NUMBER I
I B _____ -------
ZONING ADMJNISTRA TOR APPROVAL
(Pe1mit Requirements -Reverse) 1 of2
TEW FR-5 x xx20-0065