Laserfiche WebLink
State of Cellforria - Department of Fish and Wildlife <br />2017 ENVIRONMENTAL FILING FEE CASH RECEIPT <br />DFW 753,5a (Rev. 01/01/17) Previously DFG 753.5a <br />r. <br />Q Exempt from fee <br />Q Notice of Exemption (attach) <br />D CDFW No Effect Determination (attach) <br />D Fee previously paid (attach previously Issued cash receipt copy) <br />D Water Right Application or Petition Fee (Stale Water Resources Control Board only) $850.00 $ <br />D County documentary handling fee $ <br />D Other $ <br />PAYMENT METHOD: <br />Cash D credit D Check D Other TOTAL RECEIVED $ <br />S; GNATUR��.'.f-J.�-"'W" AGENCY OF FILING PRI NTEO NAME. AND TITLE <br />.A HAZEL L. BENNETT, DEPUTY CLERK <br />1 11 <br />HE <br />ORIGINAL- PROJECT APPLICANT COPY. CCFN1Ae3 COPY - LEAD AdriNCY COPY -COUNTY CLERK DFW 710.5. (Roy. 20151215) <br />30-2017 0525 <br />STATE CLEARINGHOUSE NUMBER (It applicable) <br />SEE INSTRUCTIONS ON REVERSE, TYPE OR PRINT CLEARLY. <br />LEADAOENCY <br />LEADAGENCYEMAIL <br />DATE <br />CITY OF SANTA ANA <br />05/25/2017 <br />COUNTY/STATE AGENCY OF FILING <br />DOCUMENT NUMBER <br />rOrange <br />201785000682 <br />PROJECT TITLE <br />LOCAL STREET SLURRY SEAL 2016-17 <br />PROJECT APPLICANT NAME <br />PROJECT APPLICANT EMAIL <br />PHONE NUMBER <br />CITY OF SANTA ANA PUBLIC WORKS AGENCY <br />1(714)647-5632 <br />PROJECT APPLICANT ADDRESS <br />CITY <br />STATE <br />ZIP CODE <br />ROSS ANNEX, 20 CIVIC CENTER PLAZA, 3RD FL M-36 <br />SANTA ANA <br />CA <br />92702 <br />PROJECT APPLICANT (Check appropriate box) <br />0✓ Local Publln Agency © School District ❑ Other Special Dlalricl <br />Ll State Agency ® Private Entity <br />CHECK APPLICABLE FEES: <br />D Environmental Impact Report (EIR) $5,078.25 $ 0.00 <br />D MI((gated/NegallveDeclaration (MND)(ND) $2,216,25 $ 0.00 <br />D Certified Regulatory Program document (CRP) $1,046.50 <br />$ 0.00 <br />Q Exempt from fee <br />Q Notice of Exemption (attach) <br />D CDFW No Effect Determination (attach) <br />D Fee previously paid (attach previously Issued cash receipt copy) <br />D Water Right Application or Petition Fee (Stale Water Resources Control Board only) $850.00 $ <br />D County documentary handling fee $ <br />D Other $ <br />PAYMENT METHOD: <br />Cash D credit D Check D Other TOTAL RECEIVED $ <br />S; GNATUR��.'.f-J.�-"'W" AGENCY OF FILING PRI NTEO NAME. AND TITLE <br />.A HAZEL L. BENNETT, DEPUTY CLERK <br />1 11 <br />HE <br />ORIGINAL- PROJECT APPLICANT COPY. CCFN1Ae3 COPY - LEAD AdriNCY COPY -COUNTY CLERK DFW 710.5. (Roy. 20151215) <br />