HomeMy WebLinkAboutMER20-0006_Project_Info_FormButte County Department of Development Services Tli\l SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive _ 1 ,.. A ir (Lr:--,<:: Q "2 Oroville, CA 95965 � ()L (:) �530.552.3701 Telephone 9/.. 530.538.7785 Facsimile If \ \ \.D\.D );'. l/
PROJECT INFORMATION
/\PPLlf,tNrS NAME: (lf·1pplicant is different from owner an affidavit is required.)
'I.J 6J\. L /\DD RESS: STREET. CITY, ST/\TE, & ZIP CODE5·�·--i-c\.:Jl 00"l\ .. � � �qe,s-
TELEP I IONE:
( 5 � 0 ) ct ll:.-l � 1ADDRESS:,STREET, CITY. STATE. & ZIP CODE:55 �� �I\ C<\-, \ Orx;.v �-U.e.... e,A, C\ S'Ci � S"
PROPERTY TNFORMA TlON
NAME or: PROPOSED PROJECT (if any)
EXISTING STRUCTURES (square feet)
(Check One) 0ftOPERTY IS OR PROPOSED TO OE SEWERED � PROPERTY IS OR PROPOSED TO BE ON SEPTIC
SITE SIZE (in square feel or acres)y . G (\-L � '-t O'l, Ae.-
P Ol'OSED LAND USE� -hG..t UNDER WILLIAMSON ACT CONTRACT0Yes 0No
(Check One.:) D.A1RoPERTY IS OR PROPOSED TO BE ON PUBLIC \\I ATER@ l'ROl'ERTY IS OR l'ROl'OSED TO BE ON WELL \\11\TER
APPLJCATION TYPE 0 ADMINISTRATIVE PERMIT
0 LEGAL LOT DETERMINATION
0 CONDITIONAL USE PERMITD MINOR USE PERMIT
0 COMMUNIC;\TIONS FACILITY UP/MUPD VARIANCED MINOR VARIANCE
0 I OT LINE ADJUSTMENT
@cERTIFICATE OF MERGER
0 TENTATIVE SUBDIVISION MAP
0 TENTATIVE PARCEL MAPD WAIVER OF PARCEi. MAI'
0 CERTIFICATE OF CORRECTIOND REZONE
0 GENER/\!. l'L/\N AMENDMENTD MINING /\ND RECLAMATION l'L,\N
0 DEVELOPMENT AGREEMENTD OTIIER
PROJECT DESCRIPTION
FULL DESCRIPTION OF PROPOSED PROJECT (Auach 11<:ccssary ,hccts. If this applkation is for a land di,·ision. dc.:scribc the number and si7cof parcds.)
OWNER CERTIFICATION
I CERTIFY Tl 1/\T I /1i\l l'RESENTL Y Tl IE LEG/\L OWNER OR Tl IE /\UTI IORIZED AGENT OF Tl IE OWNER OF Tl IE /\BOVE DESCRIBED l'ROl'ERTYFURTI rm. I /\(KNOWLEDGE Tl IE FILING OF Tl IIS /\Pl'I.IC;\TION /\ND CERTIFY Tl 1/\T /\I.I. OF Tl IE /\HOVE INFORM/\TION IS TRUE /\ND /\CCUR/\TI' (Iran agent is 10 be authorized, execute an affidavit ofm 1oriza1ion and include the affidavit with this application.)
SIGNATURE: _·_:._��_.."---/7-t__.._ ______________ _ D/\TE: -�5�-�1__.�f?_-_1.L_�)�-
Please contact Plannin!Z Division Staff with an ucstions.
MER20-0006