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State of California • Department of Fish and Wildlife <br />2022 ENVIRONMENTAL DOCUMENT FILING FEE <br />CASH RECEIPT <br />DFW 753.5a (REV.01101122) Previously DFG 753,5a <br />Print StartOvar Sava <br />RECEIPT NUMBER; <br />30— 07/01/2022 -- 05B6 <br />]A I G CLEARINGHOUSE NUMBER (if applicable) <br />r <br />SEE INSTRUCTIONS ON REVERSE, TYPE OR PRINT <br />CLEARLY. <br />2019�Og��� <br />LEADAGENCY <br />LEADAGENCY EMAIL <br />DATE <br />CITY OF SANTA ANA <br />07/01/2022 <br />COUNTY/STATE AGENCY OF FILING <br />DOCUMENT NUMBER <br />orange - <br />202285000573 <br />CITY OF SANTA ANA, PUBLIC WORKS AGENCY (714)647.3311 <br />PROJECTAPPLICANT ADDRESS CITY STATE ZIP CODE V' <br />220 S DAISY AVENUE SANTA ANA CA 92703 <br />PROJECT APPLICANT (Check appropriate box) <br />✓Q Local Public Agency School District [] Other Special District State Agency © Private Entity <br />CHECK APPLICABLE PEES; <br />❑ Environmental Impact Report (EIR) $3,53g.25 $ 0.00 <br />El MlllgatodlNegative Declaration (MND)(ND) $2,548,00 $ 2,648.00 <br />❑ Certified Regulatory Program (CRP) document . payment due directly to CDFW $1,203.26 $ 0.00 <br />❑ Exempt from fee <br />L7 Notice of Exemption (attach) <br />❑ COFW No Effect Determination (attach) <br />❑ Fee previously paid (attach previously Issued cash receipt copy) <br />L7 Water Right Application or Pelitlon Fee (State Water Resources Control Board only) $850,00 $ _ 0.00 <br />❑ County documentaryhandling fee $ 0.00 <br />El Other $ -- <br />PAYMENT METHOD: <br />C) Cash ❑ Credit EJ Check 0 Other TOTAL RECEIVED $ 2,648.00 <br />X '1� 'li / " IDEPLITY CLERK, SANDRA VALENCIA LOPEZ <br />ORIGINAL PROJECT APPLICANT COPY. COMPAID COPY -LEADAGENCY COPY -COUNTY CLERK DFW 753.5e(Rev. 01012022) <br />