HomeMy WebLinkAboutMER20-0005 Project Info FormButte County Depart111ent of Development Services Tl�I S1 ELLINCS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive
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530.538.7785 Facsimile
PROJECT INFORMATION Project# {Stuff Vse Only)
APPL§ANT'S AME: (If pplicant is different from owner an affidavit is required.) A ESSOR'S PARCEL UMBER:
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ADDRESS: STREET. CITY. STATE. & ZIP CODE TELEP! IONE:
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ADDRESS: STREET, CITY. ST ATE. & ZIP CODE: 'J 7 I c o>c ctJ"' � ..f r-o v/1/e C.A
PROPERTY INFORMATlON
NAME OF PROPOSED PROJECT (if any) SITE SIZE (in square feet or acres) A.: . t.t. 7 A<:..
EXISTING STRUCTURES (square feet) PROPOSED STRUCTURES ( square feet)
(Check One) 0 PROPERTY IS OR PROPOSED TO BE SEWERED � PROPERTY IS OR PROPOSED TO BE ON SEPTIC
(Check One) 0 PROPERTY IS OR PROPOSED TO BE ON PUBLIC WATER
� PROPERTY IS OR PROPOSED TO BE ON WELL WATER
APPLICATION TYPE 0 ADMINISTRATIVE PERMIT 0 LEGAL LOT DETERMINATION 0 CO DITIONAL USE PERMIT D MINOR USE PERMIT
0 TENTATIVE SUBDIVISION MAP 0 TENTATIVE PARCEL MAP D \\'/\IYER OF PARCEL MAP 0 CERTIFICATE OF CORRECTION 0 COMMUNJCATIONS FACILITY UP/MUP D VARIANCE
D Rl:/.ONE 0 GE ERAL PLAN AME DMENT D MINOR VARIANCE 0 MINING AND RECLAMATION PLAN 0 DEVELOPMENT AGREEMENT
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D LOT LINE ADJUSTMENT
il] CERTIFICATE OF MERGER
PROJECT DESCRIPTION
Fl II.I. DESCRIPTION OF PROPOSED PROJECT (Allach necessary sheets. If this application is for a land division. describe the number and size ofp���� ��� � a fk'r1f�
OWNER CERTIFICATION
I Cl:RTIFY TJ-1/\T I /\M PRESENTLY Tl IE L[G/\L OWNER OR 1111: /\U'J I IORl/.1:D AGJ:NT or Tl IL OWNER OF Tl IE A ROVE DESCRIBED l'ROl'l:RTY FlJR'I I IFR, I ACKNOWLEDGF Tl IE FILING OF Tl IIS i\PPLIC/\TION AND CERTIFY Tl !AT Al Lor Tl IE /\BOVF INFORM/\ TION IS TRUE /\ND
ACCURA'I E (I fan agen is to be authorized, execute an affidavit of authorization and include the affidavit with this application.}
SIG ATURE: ___,,,,./,::__ __________________ _ 7
Please contact Planning Division Staff with an uestions.
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MER20-0005