HomeMy WebLinkAboutDET24-0003 DPL-01Butte County Department of Development Sen-ices.●T'FORIM NOPLANNINGDIVISION
7 Count}'Center Drive,Oroville,CA 95965PlanningCenIcrPhoiie530.552.3701 Fax 530.538.7785
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DPL-01ButteCounty
Project »(Staff Use Only)^BVUl-(30CnPROJECTINFORMATIONFORM
APPLICANTS NAME:(If apniicaniis.differentfrom owner an affidavit hOcWlfV'ADnPPSS:—-
is requred.)ASSESSOR'S PARCa NUMBER:..
■,Cnj^ATE,&ZIPTODE ~'E.MAIL-C\l\Sft-X>A\‘g>CaSy\fe|(63o )-7in-
C2AtG^^VNM:a\.CrvYA FISCAL CONTACT:(the party that will handle permit fees,invoices and otherfinancialconcerre forthis application)\_CX.cQ>?xVa.i'k~LQ.Por\e
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FAX:
ADDRESS:STREET,CITY,STATE,&ZIP CODE TELEPHONE:
rs^)-pn-E-MAIL:
Tq^<Ol ,Veie,rOWNER'S NAME:^^Q,iCN tELEPHONE:£X X“
ADDRKS:STREET,CITY,STATE,&ZIPCODE:
PROPERTY INFORMATION
NAME OF PROPOSED PROJECT (if any)SITE SIZE (in square feet or acres)C-(P.C.CP-W'T-
LOCATION OF PROJECT (major cross streetsand address,if any)
ZONE GENERAL PLAN EXISTING LAND USE PROPOSED LAND USEilCZ-
EXISTING STRUCTURE (square feet)PROPOSED STRUCTURES (squarefeet)UNDER WILLIAMSON ACT CONTRACTCUYesDno
(Check One)y PROPERTY IS OR PROPOSED TO BE SEWEREDEpROPERTYisORPROPOSEDTOBEONSEPTIC
(Check One)□property is or PROPOSED TO BE ON PUBLIC WATER[^PROPERTY IS OR PROPOSED TO BE ON WELL WATER
APPLICATION TYPE (check all that apply)□MINORVARiANCE
□VARIANCE
□CERTIFICATEOF MERGER
□TENTATiVESUBDIVISlON MAP
^ADMINISTRATIVE PERMIT!0 LEGAL LOT DETERMINATION
□CONDITIONALUSE PERMIT
□MINORUSE PERMIT
□COMMUNICATIONSFACILITYUP/MUP □TENTATIVE PARCEL MAP
□WAIVER OF PARCEL MAP
□CERTIFICATEOFCORRECTION
□REZONE
□GENERAL PLAN AMENDMENT
□MiNiNGAND RECLAMATION PLAN
□DEVELOPMENT AGREEMEMT
□other □LOT UNE ADJUSTMENT
PROJEa DESCRIPTION
FULL DESCRIPTION OF PROPOSED PROJECT (Attach necessarysheets.lfthis application is for a land division,describe the number and size of parcels.)
OWNER CERTIFICATION
1 CERTIFY THAT I AM PRESENTLY THE LEGAL OWNER OR THE AUTHORIZED AGENT OF THE OWNER OF THE ABOVE DESCRIBED PROPERTYFURTHER,I ACKNOWLEDGE THE FILING OF THIS APPLICATION AND CER
ACCURATE.(If an agent is to be authorized,execute an affidavit ofauti
(THAT ALL OF THE ABOVE INFORMATION IS TRUE AND
ization and indudethe affidavit with this application.)
DATE:SIGNATURE.
Please contact Planning Division Staff with any questions.