HomeMy WebLinkAboutDET21-0008_Project_Info_Form' Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 530. 552.3701 Telephone530.538. 7785 Facsimile
PROJECT INFORMATION Project# (Staff Use Only)
APPLICANT'S NAME: (If applicant is different from owner an affidavit is required.) ASSESSOR'S PARCEL NUMBER: H�tv/l-te..vr-J :Trt. Tllu.r�t."tJ L v,,J 7"fl.v r O?J... -3?o -(!)/O
ADDRESS: STREET, CITY, STATE, & ZIP CODE: , ...S:-A � A.!' A.8 o � f O {Jo'/-'J..c:, Y;l.. e.1 /v) vi/� Ce. . ? S'?'-.r
PROPERTY INFORMATION NAME OF PROPOSED PROJECT (if any) SITE SIZE (in square feet or acres) C.+LOCATION OF PROJECT (major cross streets and address, if any)� 1 NvP..L..... T?:>rv s w �.e-f Fl,-t r ,�ZONE GENERAL PLAN EXISTING LAND USE � Vo A -C(o �(A,l° PROPOSED LAND USE No� .r � EXISTING STRUCTURES (square feet) PROPOSED STRUCTURES ( square feet) UNDER WILLIAMSON ACT CONTRACT 0Yes No C:, /�&O (Check One) (Check One) 0 PROPERTY IS OR PROPOSED TO BE SEWERED .RJ PROPERTY IS OR PROPOSED TO BE ON SEPTIC 0 PROPERTY IS OR PROPOSED TO BE ON PUBLIC WATER � PROPERTY IS OR PROPOSED TO BE ON WELL WATER
APPLICATION TYPE
0 ADMINISTRATIVE PERMIT � LEGAL LOT DETERMINATION
0 CONDITIONAL USE PERMIT D MINOR USE PERMIT
BUTTE
COUNTY
D COMMUNICATIONS FACILITY UP/MUl()CT 16 2021OvARIANCE D MINOR VARlANCE DEVELOPMtNl 0 LOT LINE ADJUSTMENT SERVlCES D CERTIFICATE OF MERGER
0 TENTATIVE SUBDIVlSION MAP D TENTATIVE PARCEL MAP 0 WAIVER OF PARCEL MAP 0 CERTIFICATE OF CORRECTION
0REZONE 0 GENERAL PLAN AMENDMENT 0 MINING AND RECLAMATION PLAN 0 DEVELOPMENT AGREEMENT
OoTHER
PROJECT DESCRIPTION
FULL DESCRIPTION OF PROPOSED PROJECT (Attach necessary sheets. If this application is for a land division, describe the number and size ofparcels.) fflvkA--7:y j s JrJ T#-. 1)1,).,.J (Y)A.r.JN -::rvd,,.e__yAR.{Vr A/<.tuqSo A C o C -1,L-Uld.4.! :ro 1/HL /Jo� f.JL/l ... LA "'o ./)e �let�� w;r;
OWNER CERTIFICATION
r CERTIFY THAT r AM PRESENTL y THE LEGAL OWNER OR THE AUTHORIZED AGENT OF THE OWNER OF THE ABOVE DESCRIBED PROPERTY.
FURTHER, I ACKNOWLEDGE THE FlLLNG OF THIS APPLICA TlON AND CERTIFY THAT ALL OF THE ABOVE INFORMA T!ON IS TRUE AND
ACCURATE. (Ifan agent is to be authorized, execute an affidavit of authorization and include the affidavit with this application.)
DATE: /0-/5-�"'-\ SIGNATURE:� � �
Please contact Plannin Division Staff with an uestions.
DET21-0008