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• ~ <br />• *ENYIROHMENTA!- DECLARATION <br />• (CALIF. 11.4) . <br />NAME AND ADDRESS OF,,APPLICAxT OR LEAD AGENCY= <br />`~ ::a <br />.FOR COURT USE OuLY ^-~ <br />.. 9 ~ ~ LINTY <br />ALAM E ~A <br />" ~ APR Q5 2000 <br />PA ICK 0'C N L, Gounty Clerk <br />. . y _ ~~ <br />. ~~ .~ <br />. _CLERKS <br />CLASSIFICATION OF EHYIRONMENTAL• DOCUMENT: ~ . <br />i . NOTICE ~OF E1CEI~tPTION/STATEt~NT OF EXQ~PTION ~ _ PLU 117 <br />[ A - STATUTORILY OR CATE6pRICALLY EXEtdPT <br />525.00 (Tw~en i<y-five Dol i nrs } = ~ CLERK `S FEE <br />[,] B - DE MINIMUS IMPACT -CERTIFICATE OF FES DCEl~tPTION REQUIRED PLU 7i7 <br />525.00 (Twenty-five Dollars) CLERK . <br />2. ttOTICE OF OETERt~It1ATI0N -FEE REQUIRED PLU 11.6 <br />[ ] A - NfGATIYE DECLARATION. ~ <br />51,250.00 (Twelve Hundred Fifty~Do77ars) - <br />STATE FILItK; FEE. <br />.525.00 (Tw~en ty-five Dol 1 ars) -CLERK'S. FEE . <br />[ ] 8 - ENYIRON'MENTAL ItdPACT REPORT - PLU 11.5 <br />5850.00 (Ei g#tt Hundred Fifty Doi 1 nrs } -STATE <br />FILIt~tG FEE <br />525.00 (T~ren ty-five Dal i ars) -CLERK'S FEE <br />3. [ ~ OTHER (Specify} ~ ~ ~ PLU li7 <br />525.00 (Twat ty-five o ars . - <br />*'iNIS FORM MUST' BE LOhSPLETED AND SUBMITTED KITH ALL EKYiR01iM.ENTAL pOCUMENTS FILED <br />PITH THE AL.At~DA COUNTY CLERK'S OFFICE. <br />FOUR COPIES OF ALL NECESSARY pOCUMEt~iTATION AR.E REQUIREO FOR FiIING PURPOSES. <br />APPLICABLE FEES ~t~tttST BE PAID AT THE TIME 0~ FILING AR ENYIRONt~NTAL DOCUMENT KITH <br />THE ALAMEDA COUNTY GLERK'S OFFICE. <br />MAKE CHECK PAYABLE T0: ALAMEDA COUNTY, CLERK <br />Rev. 7 /1 S/9l -1056C <br />