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Home My WebLink AboutLLA21-0006_Project_Info_FormsD Butte County Department of Development Services PERMIT CENTER 7 County Center Drive, Oroville, CA 95965 , Main Phone 530.552.3700 Planning Phone 530.552.3701 Fax 530.538.7785 Planning Email: DSP!annim!/(1 huttccountv.nct PROJECT INFORMATION FORM FORM NO DPL-01 1 Project# (Staff Use Onlv) I APPLICANT'S NAME: (lf applicant is different from owner an affidavit is required.) ASSESSOR'S PARCEL NUMBER: _l>a� · · -�� v-r-OS-0 -O�o -oo� ADDRESS: STREET, CITY, STATE, & ZIP CODE TELEPHONE: \ "I "\lo Lo+:b:i \h� br. 1 �.Jla,.,e. 1 CA � b...1.-____ -+-'-< n..;...::_o--'J'-'.S'--�=-i:::....-.......;2.;=�...:....t>=o�-e.MA1t: FAX: tf Mir-l�· ,..N}A...>. l.i>r'\ · c ADDRESS: STREET, CITY, STATE, & ZIP CODE TEtEPHONE: E-MAIL· OWNER'S NAME: I ( l I TELEPHONE: { ) ADDRESS: STREET, CITY, STATE, & ZIPCODE: PROPERTY INFORMATION NAME OF PROPOSED PROJECT lif anv) SITE SIZE (in square feet or acres) LOCATION Of PROJECT (major cross streets and address, if any) ZONE I GENERAL PlAN I EXISTING LAND USE PROPOSED LAND USE EXISTING STRUCTURES (square feet) I PROPOSED STRUCTURES ( square feet) UNDER WILLIAMSON ACT CONTRACT Dves DNo (Che<:k One) 8 PROPERTY IS OR PROPOSED TO BE SEWEREDPROPERTY IS OR PROPOSED TO SE ON SEPTIC (Check One) 0PROPERTY IS OR PROPOSED TO BE ON PUBLIC WATER 0PROPERTY IS OR PROPOSED TO BE ON WELL WATER 0 ADMINISTRATIVE PERMIT 0 LEGAL LOT DETERMINATION 0 CONDITIONAL USE PERMIT 0 MINOR USE PERMIT 0 COMMUNICATIONS FACILITY UP/MUP 0 LOT LINE ADJUSTMENT APPLICATION TYPE (check all that apply) 0 MINOR VARIANCE O CERTIFICATE OF CORRECTION D VARIANCE D REZONE 0 CERTIFICATE OF MERGER O GENERAL PLAN AMENDMENT 0 TENTATIVE SUBDIVISION MAP O MINING ANO RECLAMATION PLAN 0 TENTATIVE PARCEL MAP O DEVELOPMENT AGREEMENT 0 WAIVER OF PARCEL MAP 00THER PROJECT DESCRIPTION ---------- FULL DESCRIPTION OF PROPOSED PROJECT (Attach necessary sheets. If this application Is for a land division, describe the number and size of parcels.) OWNER CERTIFICATIO I CERTIFY THAT I AM PRESENTLY THE LEGAL OWNER OR THE AUTHORIZED AGENT OF THE OWNER OF THE ABOVE DESCRIBED PROPERTY. i'URTHER, I ACKNOWLEDGE THE FILING OFTHIS APPLICATION A FY THAT ALL OfTHE ABOVE INFORMATION 15 TRUE AND ACCURATE. (If an agent is to be authorized, e11ecute an affidavi of authoriza 1 1davit with this application.) DATE: 2 -I'\ -2.0Z.) Same Same Skyway and Lofty Lane AG-160 AG Residential Residential Dwelling/Garage - 3,700 XNone X X X 39.39 acres DocuSign Envelope ID: 26109053-EA86-42A8-A9AF-824651256779 D Butte County Department of Development Services PERMIT CENTER FORM NO 7 County Center Drive. Oroville, CA 95965 DPL-01 Main Phone 530.552.3700 Planning Phone 530.552.3701 Fax 530.538.7785 Planning Email: DSP!anning(tilbuttccounty.nct PROJECT INFORMATION FORM Project II (Staff Use Only) FISCAL CONTACT: (the party that will handle permit fees, invoices and other financial concerns for this application) ADDRESS: STREET, CITY, STATE, & ZIP CODE TELEPHONE: (MAIL: OIJllt'.IER'S NAME: \? :J V --A'[ (\e, TELEPHONE: 5.30 SJ-\-ADDRESS: STREET, CITY, STATE, & ZIP CODE: Lo++ PROPERTY INFORMATION Vo. ret.d \.SC.. NAME OF PROPOSED PROJECT if any) SITE SIZE (in square feet or acres) EXISTING STRUCTURES (square feet) UNDER Willi� SON ACT CONTRACT Dves )q°No (Check One) 0PROPERTY IS OR PROPOSED TO BE SEWERED �ROPERTY IS OR PROPOSED TO BE ON SEPTIC (Check One) 0 PROPERTY IS OR PROPOSED TO BE ON PUBLIC WATER �ROPERTY IS OR PROPOSED TO BE ON WELL WATER 0 ADMINISTRATIVE PERMIT 0 LEGAL LOT DETERMINATION 0 CONDITIONAL USE PERMIT 0 MINOR USE PERMIT 0 COMMUNICATIONS FACILITY UP/MUP ij3-LOT LINE ADJUSTMENT APPLICATION TYPE (check all that apply) 0 MINOR VARIANCE O CERTIFICATE OF CORRECTION D VARIANCE D REZONE 0 CERTIFICATE OF MERGER O GENERAL PLAN AMENDMENT 0 TENTATIVE SUBDIVISION MAP O MINING ANO RECLAMATION PLAN 0 TENTATIVE PARCEL MAP O DEVELOPMENT AGREEMENT D WAIVER OF PARCEL MAP OoTHER ----------- ·-\·, ...-, .. ;;� _ .. ,.::>·:: '.·' · ,.,rl;\(),Je,c.:r.J?es��·P:r•q!" ... ,., ....... ,.c, ./:(:. ,.. . FULL DESCRIPTION OF PROPOSED PROJECT (Attach necessary sheets. If this application is for a land division, describe the number and size of parcels.) OWNER CER;JICATION I CERTIFY THAT I AM PRESENTLY THE LEGAL OWNER OR THE AUTHORIZED AGENT OF THE OWNER OF THE ABOVE DESCRIBED PROPERTY. FURTHER, I ACKNOWLEDGE THE FILING OF THIS APPLICATION AND CERTIFY THAT ALL OF THE ABOVE INFORMATION IS TRUE AND AC'f !Nftlf2£ agent is to be authorized, execute an affidavit of authorization HJ!ilMWr,etJltiiffidavit with this application.) DATE: SIGNATURE: ------11---'a_ll-'l_�---r-------------- 9DS6213FD0434F5 ... n1 .......... �- ,..--+""',.. .. nl""'r"'"''nrr r'\i"ieinn Ct"l.ff u,ith -:,nu n11oc-'tinnc: 34.12 acres (-008) and 14.53 acres (-009) 3,000 (-009)None D Butte County Department of Development Services FORM NO PERMIT CENTER 7 County Center Drive, Oroville, CA 95965 DPL-01 Main Phone 530.552.3700 Planning Phone 530.552.3701 Fax 530.538.7785Planning Email: DSPlanninllc@buttecountv.net PROJECT INFORMATION FORM Project# (Staff Use Only) APPLICANT'S NAME: (If applicant is different from owner an affidavit is required.) ASSESSOR'S PARCEL NUMBER: tP cl e-,,_ � .so O>?> - o·..,,D -oob STREET, CITY, STATE, & ZIP CODELo l.);� i:)r _ TELEPHONE: __(_63_0) £'/1-{;, ;f 2 J E-MAIL:FAX:l?, V £-S. e... /; v ti} /'}') > n . c_o vri FISCAL CONTACT: {the party that will handle permit fees, invoices and other financial concerns for this application) ADDRESS:STREET, CITY, STATE, & ZIP CODE TELEPHONE: E-MAIL: TELEPHONE:( S"'3c �'t-b't� 7STREET, CITY, STATE, & ZIP CODE: i /-?a ai. d/.i-c:.. ( CA- l' �-, 6 Y V veev j;) T/ /pROPERTY INFORMATION NAME OF PROPOSED PROJECT (if any)L-c:; . ///'e-.., i>r,"� XISTING STRUCTURES (square feet):s so-e SITE SIZE (in square feet or acres)�- a c . EXISTING LAND USE/2es; de-Pi Lr<L PROPOSED STRUCTURES ( square feet) PROPOSED LANO USE UNDER WILLIAMSON ACT CONTRACTDves �No (Check One) (Check One) 0 PROPERTY IS OR PROPOSED TO BE SEWERED Ga'i>ROPERTY IS OR PROPOSED TO BE ON SEPTIC 0 PROPERTY IS OR PROPOSED TO BE ON PUBLIC WATERliaPROPERTY IS OR PROPOSED TO BE ON WELL WATER 0 ADMINISTRATIVE PERMIT . 0 LEGAL LOT DETERMINATION 0 CONDITIONAL USE PERMIT0 MINOR USE PERMIT 0 COMMUNICATIONS FACILITY UP/MUPCi?'CoT LINE ADJUSTMENT APPLICATION TYPE (check all that apply) 0 MINOR VARIANCE O CERTIFICATE OF CORRECTIOND VARIANCE D REZONE 0 CERTIFICATE OF MERGER O GENERAL PLAN AMENDMENT 0 TENTATIVE SUBDIVISION MAP O MINING AND RECLAMATION PLAN0 TENTATIVE PARCEL MAP O DEVELOPMENT AGREEMENTD WAIVER OF PARCEL MAP OoTHER PROJECT DESCRIPTION ----------- FULL DESCRIPTION OF PROPOSED PROJECT (Attach necessary sheets. If this application is for a land division, describe the number and size of parcels.) I CERTIFY THAT I AM PRESENTLY THE LEGAL OWNER OR THE AUTHORIZED AG T OF THE OWNER OF THE ABOVE DE:SCRIBED PROPERTY.FURTHER, I ACKNOWLEDGE THE FILING OF THIS APPLICATION ANO CERTIFYT ALL OF THE ABOVE INFORMATION IS TRUE AND ACCURATE. (If an agent is to be authorized, execute an affidavit of authorizat o nd include the affidavit with this application.) DATE:._/�/-�_/ !.____..:?_0_.2.._( __