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State of California - Department of Fish and Wildlife <br />2026 ENVIRONMENTAL DOCUMENT FILING FEE <br />CASH RECEIPT <br />DFW 753.5a (REV. 01/01/25) Previously DFG 753.5a <br />(RECEIPT NUMBER: <br />30-03118/2025-0152 <br />CLEARINGHOUSE NUMBER (if applicable) <br />SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY. <br />LEADAGENCY LEAD AGENCY EMAIL DATE <br />CITY OF SANTA ANA 0311812025 <br />COUNTYISTATE AGENCY OF FILING DOCUMENT NUMBER <br />ORANGE COUNTY 202585000201 <br />PROJECT TITLE <br />BRISTOL STREET REHABILITATION <br />PROJECT APPLICANT NAME PROJECT APPLICANT EMAIL PHONE NUMBER <br />CITY OF SANTA ANA (714) 647-5647 <br />PROJECT APPLICANT ADDRESS CITY STATE ZIPCODE <br />20 CIVIC CENTER PLAZA M-36 SANTA ANA CA 92702 <br />PROJECT APPLICANT (Check appropriate box) <br />Eg Local Public Agency ❑ School District ❑ Other Special District ❑ State Agency ❑ Private Entity <br />CHECK APPLICABLE FEES: <br />❑ Environmental Impact Report (EIR) $ 4,123.50 $ <br />❑ Mitigated/Negative Declaration (MND)(ND) $ 2,068,75 $ <br />® Certified Regulatory Program (CRP) document - payment due directly to CDFW $ 1,401.75 $ <br />ICJ Exempt from fee <br />M 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 Control Board only) $ 850.00 $ <br />© County documentary handling Fee $ 50.00 $ <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 Melissa Gomez Deputy Clerk <br />ORIGINAL- PROJECT APPLICANT COPY - CDFWIASB COPY - LEAD AGENCY COPY • COUNTY CLERK DFW753.5a (Rev.01012025I <br />