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State of California-Department of Fish and Wildlife <br /> 2025 ENVIRONMENTAL DOCUMENT FILING FEE <br /> CASH RECEIPT - <br /> IDFW 753.5a(REV.01/01126)Previously DFG 763.5a ......... - <br /> P.:Firit' StartOver ` l3ave <br /> RECEIPT NUMBER: <br /> 30— 01/13/2025 — 0012 <br /> STATE CLEARINGHOUSE NUMBER(if applicable) <br /> SEE INSTRUCTIONS ON REVERSE.TYPE ORPRINTCLEARLY. <br /> LEADAGENCY I LEADAGENCY EMAIL DATE <br /> OCPW, DEVELOPMENT SERVICES 01/13/2025 <br /> COUNTY/STATE AGENCY OF FILING DOCUMENT NUMBER <br /> orange Ej 202585000014 <br /> PROJECT TITLE <br /> FAIRVIEW ST IMPROVEMENTS. MONTE CARLO <br /> PROJECT APPLICANT NAME PROJECT APPLICANT EMAIL PHONE NUMBER <br /> OCPW (714)6475647 <br /> PROJECT APPLICANTADDRESS CITY STATE ZIP CODE <br /> 20 CIVIC CENTER PLAZA SANTA ANA CA 92702 <br /> PROJECT APPLICANT(Checkappraprlate box) <br /> Q Local Public Agency ❑ School District ❑ Other Special District ❑ State Agency ❑Private Entity <br /> CHECK APP JCA13LE FEES. <br /> ❑ Environmental Impact Report(EIR) $4,123,60 $ 0.00 <br /> ❑ MIIlgated/Negative Declaration(MND)(ND) $2,968.75 $ 0.00 <br /> ❑ Certified Regulatory Program(CRP)document-payment due directly to CDFW $1,401.76 $ 0.00 <br /> El Exempt from fee <br /> El Notice of Exemption(attach) <br /> ❑ CDFW No Effect Determination(attach) <br /> ❑ Fee previously paid(attach previously Issued cash receipt copy) <br /> ❑ Water Right Application or Petition Fee(State Water Resources Contra!Board only) $850.00 $ 0.00 <br /> ❑ County documentary handling fee $ 0.00 <br /> �] Other $ <br /> PAYMENT METHOD: <br /> ❑ Cash ❑ Credit ❑ Check ❑ Other TOTAL RECEIVED $ 0.00 <br /> SIGNATURE AGENCY OF FILING PRINTED NAME AND TITLE <br /> X JACQUELINE CHABOYA, DEPUTY <br /> ORIGINAL-PROJECTAPPUGMIT COPY-CPFWlASS COPY-LEADAGENGY COPY-G6l1NTYCLERK OFW70.5a(Rov.01012026) <br /> 9-9 <br />