Laserfiche WebLink
i <br /> i <br /> Stato of Callfomla-Department of Fish and Wildlife <br /> ... 2025 ENVIRONMENTAL DOCUMENT FILING FEE <br /> _ CASH RECEIPT <br /> DFW 753.5a(REV.01101125)Previously DF(3 753.5a <br /> RECEIPT NUMBER: <br /> 30-0413012025.0309 t <br /> STATE CLEARINGHOUSE NUMBER flf appllcable) <br /> SEE INSTRUCTIONS ON REVERSE.TYPE OR PRINT CLEARLY. <br /> LEADAGENCY LEAD AGENCY EMAIL DATE <br /> CITY OF SANTA ANA 0413012025 <br /> COUNTYISTATP AGENCY OF FILING DOCUMENT NUMBER <br /> ORANGE COUNTY 202565000394 <br /> PROJ ECT TI7t.E <br /> 25-60t3 MCFADDEN AVENUE T8PP <br /> PROJECT APPLICANT NAME PROJECT APPLICANT EMAIL, PHONE NUMBER <br /> CITY OF SANTA ANA,PUBLIC WORKS AGENCY (714)047-5033 <br /> PtOJECTAPPLICANTADDRESS CITY STATE ZIP CODE <br /> 20 CIVIC CENTER PLAZA M-36 SANTA ANA CA 92702 <br /> PROJECT APPLICANT(Check appropriate box) <br /> Local Public Agency © School District Q Other Speclal DIstricl []State Agency Private Entity <br /> CHUCK APPLICABLE FEES: <br /> ❑ Environmental Impact Report(EIR) $ 4,123.60 s - <br /> ❑ MitlgetedlNegative Declaration(MND)(ND) $ 2,968.75 <br /> ❑ Certilled Regulatory Program(CRP)document-paymentdue directly to CDl-W S 1,401.75 $ <br /> IM Exempt from fee <br /> ® Notice of Examption(attach) <br /> ❑ CDFW No Effect Daterminatlon(attach) <br /> ❑ Fan previously paid(attach previously issued cash receipt copy) <br /> [3 Water Right Appilcation or Petition Fee(State Water Resources Control Board only) �. 850,p0 $ <br /> ❑ County documentary handling Fee $ 50.00 $ <br /> ❑ Other $ <br /> PAYMENT METHOD; <br /> ❑ Caeh 0 Credit 0 Check I7 Other TOTAL RECEIVED 0.00 <br /> SIGNATURE AGENCY OF FILING PRINTED NAME AND TITLE <br /> X �� Mellma Gomez Deputy Clerk <br /> ORIGINAL-PROJECrAPMOAN'r COPY-CDFW1Ae0 COPY-LEAD AGENCY COPY•CODUrYCLVRK DFW75&6atRov.MUM) <br />