HomeMy WebLinkAbout1.MER23-0008 Project Information Form□
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: DSPlanning(@buttecounty.net
PROJECT INFORMATION FORM
FORM NO
DPL-01
I Project# (Staff Use Only)
APPLICANT'S NAME: (If applicant is different from owner an affidavit is required.) John Martin Cullen, Trustee, The Cullen Family Trust date March 13, 2017 ASSESSOR'S PARCEL NUMBER:
ADDRESS: STREET, CITY, STATE, & ZIP CODE 3512 N Prospect Ln, Garden City, Idaho, 83714 E-MAIL:boisecullen@gmail.com
062 -160 -013 & -015TELEPHONE: (208 ) 890 -6165 FAX:
FISCAL CONTACT: (the party that will handle permit fees, invoices and other financial concerns for this application)
John Martin Cullen ADDRESS: STREET, CITY, STATE, & ZIP CODE 3512 N Prospect Ln, Garden City, Idaho, 83714 E-MAIL:
boisecullen@gmail.com
OWNER'S NAME: The Cullen Family Trust, dated March 13, 2017 ADDRESS: STREET, CITY, STATE, & ZIP CODE: 3512 N Prospect Ln, Garden City, Idaho, 83714 PROPERTY INFORMATION
TELEPHONE: ( 208 )890 -6165
TELEPHONE: (208 ) 890 -6165
NAME OF PROPOSED PROJECT (if any) SITE SIZE (in square feet or acres) .262 acres LOCATION OF PROJECT (major cross streets and address, if any)
198 Lakeside Way, Berry Creek, CA 95916 ZONE I GENERAL PLAN I EXISTING LAND USE residential PROPOSED LAND USE residential EXISTING STRUCTURES (square feet) I PROPOSED STRUCTURES ( square feet) none 2007 UNDER WILLIAMSON ACT CONTRACT Dves lil No(Check One) 0 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 0 PROPERTY IS OR PROPOSED TO BE ON WELL WATER
0 ADMINISTRATIVE PERMIT 0 LEGAL LOT DETERMINATION 0 CONDITIONAL USE PERMIT □MINOR USE PERMIT□COMMUNICATIONS FACILITY UP/MUP0 LOT LINE ADJUSTMENT
APPLICATION TYPE (check all that apply) 0 MINOR VARIANCE O CERTIFICATE OF CORRECTION 0 VARIANCE □REZONE� CERTIFICATE OF MERGER O GENERAL PLAN AMENDMENT0 TENTATIVE SUBDIVISION MAP O MINING AND RECLAMATION PLAN0 TENTATIVE PARCEL MAP O DEVELOPMENT AGREEMENT0 WAIVER OF PARCEL MAP □OTHER
PROJECT DESCRIPTION
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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.)
merger of lots 99 and 102 of the Feather River Forest Homes Unit 1 Subdivision recorded April 22,
1928 in Book 8 of maps, pages 29A and 30A
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 authorization and include the affidavit with th·s application.)
DATE: 5/20/22023 SIGNATURE: --''--"-A'L/-----,,-V...f-.!:::!.::.!:::...�--l-.,,+A4Lb---===�-----
Please contact Planning D vision Staff with any questions.