HomeMy WebLinkAboutADM21-0116 TEMP HOUSING APPLICATION - APPROVED(Permit Requirements – Reverse) 1 of 2
RECREATION VEHICLE AS TEMPORARY RESIDENCE
ADMINISTRATIVE PERMIT (BCC 24-174 ET SEQ.)
APPLICANT INFORMATION
APPLICANT’S NAME PHONE NUMBER ( )
MAILING ADDRESS CITY STATE ZIP CODE
E-MAIL
PROPERTY INFORMATION
PROPERTY OWNER (if different from the applicant) ASSESSOR’S PARCEL NUMBER
SITE ADDRESS CITY ZIP CODE
SIZE OF PROPERTY EXISTING LAND USE TYPE OF PERMITTED WATER SYSTEM?
WELL SHARED WELL SPRING OTHER ________
PROPOSED POWER SOURCE?
PG&E GENERATOR SOLAR BATTERY OTHER __________
PERMITTED ON-SITE SEPTIC SYSTEM?
YES NO
DESCRIPTION OF PROPOSED ACTIVITIES, LENGTH OF STAY, TIME OF YEAR, VEHICLE TYPE (use separate sheet, if necessary)
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. I 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 SIGNATURE DATE
STAFF USE ONLY
APPLICATION REVIEWER ZONE DISTRICT EH CLEARANCE
YES NO N/A
PUBLIC WORKS CLEARANCE
YES NO N/A
PROJECT NUMBER
ADM_____-_________
BUILDING PERMIT REQUIRED?
YES NO N/A
BUILDING PERMIT NUMBER
B_____-_________
ZONING ADMINISTRATOR APPROVAL DATE
Butte County Department of Development Services PLANNING DIVISION
7 County Center Drive, Oroville, CA 95965
Planning Center Phone 530.552.3701 Fax 530.538.7785 dsplanning@buttecounty.net
FORM NO
PLA-04
Rowland Hickel 09/07/2021