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r State of Califomia—Natural Resources Agency <br />CALIFORNIA DEPARTMENT OFFISH AND WILDLIFE <br />;S 2015 ENVIRONMENTAL FILING FEE CASH RECEIPT <br />RECEIPT# <br />30-2016 877 <br />STATE CLEARING HOUSE#0tappkmib ) <br />SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY NIA <br />LEADAGENCY DATE <br />CITY OF SANTAANA 1 08/18/2016 <br />— • •�-^-" JVUUMCIN1 NUW@StR <br />Orange 2016650008P3 <br />ri V lt4i 111Lt <br />SANTA ANA & 5TH ST PROTECTED BIKE LANES <br />KENNY NGUYEN - CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA, 3RD FLOOR M-36 <br />SANTA ANA I CA 192702 <br />E] Local PublicAgeney School District ® Other Spools l District EJ State Agency Private Entity <br />CHECK APPLICABLE FEES: <br />0 Environmental Impact Report (EIR) $3,070.00 $ O.no <br />MIdgated/Negative Declaration (MND)(ND) $2,210.25 $ n.nn <br />Application Fee Water Diversion (State Water Resources Control Swirl only) $850.00 $ 0.00 <br />Projects Subject to Certified Regulatory Programs (CRP) $1,043.75 $ 0,00 <br />Il County Administrative Fee $50.00 $ 0.00 <br />Q Project that is exempt from fees <br />Q Notice of Exemption (attach) <br />I7' CDFW No Effect Determination (attach) <br />EJ Other $ <br />PAYMENT METHOD! <br />EJ Cash F1 Credit QCheck QOther TOTAL RECEIVED $ 0.00 <br />SIGNATURE PRINTED NAME AND TITLE <br />NADIA AL OBAIDI, DEPUTY CLERK <br />ORIGINAL- PROJECT APPLICANT COPY -COPMAS13 COPY-LEADAGENCY COPY-COUNWCLERK DFG 753.5a(Rev. 1 Ill 4) <br />