HomeMy WebLinkAboutMER23.0001.1_Project Info FormD
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 530.538.7785 Planning Email: DSPlanning@buttecounty.net
PROJECT INFORMATION FORM I Project# (Staff Use Only)
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APPUCANT'S NAME: (If applicant is different from owner an affidavit is required.) Tison Gray
ADDRESS: STREET, CITY, STATE, & ZIP CODE 13719 West Park Dr., Magalia, CA, 95969
E-MAIL:tisongray85@gmail.com
ASSESSOR'S PARCEL NUMBER: 066-300-041
TELEPHONE: ( 530 ) 828 - 2779
FAX:
(
FISCAL CONTACT: (the party that will handle permit fees, invoices and other financial concerns for this application) Same as applicant
ADDRESS: STREET, CITY, STATE, & ZIP CODE TELEPHONE:
E-MAIL:
OWNER'S NAME: Same as applicant TELEPHONE:
( ) ADDRESS: STREET, CITY, STATE, & ZIP CODE:
PROPERTY INFORMATION
NAME OF PROPOSED PROJECT (if any) SITE SIZE (in square feet or acres)
LOCATION OF PROJECT (major cross streets and address, if any)
13719 & 13723 West Park Drive, Magalia, CA, 95954
EXISTING LAND USE PROPOSED LAND USE ZONE RR-5 GENERAL PLAN RR Single family residence Single family residence
EXISTING STRUCTURES (square feet) 2,000 sf
(Check One)
PROPOSED STRUCTURES ( square feet) NIA UNDER WILLIAMSON ACT CONTRACT Dves lil No
□ PROPERTY IS OR PROPOSED TO BE SEWERED
�PROPERTY IS OR PROPOSED TO BE ON SEPTIC
(Check One)
� PROPERTY IS OR PROPOSED TO BE ON PUBLIC WATER □ PROPERTY IS OR PROPOSED TO BE ON WELL WATER
□ADMINISTRATIVE PERMIT0 LEGAL LOT DETERMINATION□CONDITIONAL USE PERMIT□MINOR USE PERMIT□COMMUNICATIONS FACILITY UP/MUP0 LOT LINE ADJUSTMENT
APPLICATION TYPE (check all that apply) □MINOR VARIANCE □CERTIFICATE OF CORRECTION0 VARIANCE □REZONE
� CERTIFICATE OF MERGER □GENERAL PLAN AMENDMENT□TENTATIVE SUBDIVISION MAP □MINING AND RECLAMATION PLAN□TENTATIVE PARCEL MAP □DEVELOPMENT AGREEMENT0 WAIVER OF PARCEL MAP □OTHER
PROJECi DESGRliPTION
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FULL DESCRIPTION OF PROPOSED PROJECT (Attach necessary sheets. If this application is for a land division, describe the number and size of parcels.) The merging of properties APN 066-300-033 & 034 (10010 sf & 10020 sf respectfully)
OWNER CERTIFICATION
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
ACCURATE. (If an agent is to be authorized, execute an affidavit of authori nd /nclude the affidavit with this application.)
DATE: 2/04/2023