HomeMy WebLinkAboutMISC17-0018 Burn Down Form Department of Development Services Tim Snellings, Director
Pete Calarco, Assistant Director
7 County Center Drive T: 530.538.7601
Oroville, California 95965 F: 530.538.7785 buttecounty.net/dds
Burn Down Letter Request Form
Applicant's Contact Information:
Name: __________________________________________________________________
Email: _________________________________________ Phone: ___________________
Address: ________________________________________________________________
City: _________________________ State: ______ Zip code: _________
Address of Property: _______________________________________________________
City: _________________________ State: ______ Zip code: _________
Assessor Parcel Number of Property (if known):_____-_____-_____
Please describe/identify structure(s) on property that require the Burn Down Letter:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Person(s)/Company/Firm letter will be addressed to:
________________________________________________________________________
Letter Delivery Method (as applies):
Address: _______________________ City: _________ State: ____ Zip code: __________
Delivery Fax: (___) ____-______
Delivery Email: ____________________________________________________________
PLEASE NOTE THAT FEE OF: $171.97 IS DUE BEFORE LETTER REQUEST FORM
CAN BE PROCESSED – Checks are payable to “Butte County”