Laserfiche WebLink
~~. <br />. ~ ` ' ' • *ENVIRONMENTAL DECLARATION <br />(CALIFORNIA FISH AND GAME CODE SEC. 711.4) <br />FOR COLT ~tS~O~ D <br />NAME AND ADDRESS OF APPLICANT OR LEAD AGENCY: ALAM E DA COUNTY <br />City of San Leandro ~ FEB 2 8 2400 <br />,~ . .~, <br />Development Services Department , ~ ~ / ,_, ~,f, _ 1 PA ICK 'CO EL COUniy Clerk <br />835 East 14th Street -~•<>~ - <br />err n.rr_ ~Tn <br />1'1L11`IV 1 V. <br />San Leandro CA 94577 <br />~~O r ~?' <br />CLASSIFICATION OF ENVIRONMENTAL DOCUMENT: <br />1. NOTICE OF EXEMPTION/STATEMENT OF EXEMPTION <br />[ ] A -STATUTORILY OR CATEGORICALLY EXEMPT <br />$25.00 (Twenty-five Dollars) -CLERK'S FEE <br />(] B - DE MINIMUS IMPACT -CERTIFICATE OF FEE EXEMPTION REQUIRED <br />$25.00 (Twenty-five Dollars) -CLERK'S FEE <br />2. NOTICE OF DETERMINATION -FEE REQUIRED <br />] -NEGATIVE DECLARATION <br />$1,250.00 (Twelve Hundred Fifty Dollars) -STATE FILING FEE <br />$25.00 (Twenty-five Dollars) -CLERK'S FEE <br />[ ] B -ENVIRONMENTAL IlvIPACT REPORT <br />$850.00 (Eight Hundred Fifty Dollars) - STAi'r, FILING FEE <br />$25.00 (Twenty-five Dollars) -CLERKS FEE <br />3. [X] OTHER (Specify) Notice of Determination with De Minimis Impact <br />$25.00 (Twenty-five Dollars) -CLERK'S FEE <br />PLU 117 <br />CLERK'S <br />USE ONLY <br />PLU 117 <br />PLU 117 <br />PLU 116 <br />PLU 115 <br />*THIS FORM MUST BE COMPLETED AND SUBMITTED WITH ALL ENVIRONMENTAL DOCUMENTS <br />FILED WITH THE ALAMEDA COUNTY CLERK'S OFFICE. <br />FOUR COPIES OF ALL NECESSARY DOCUMENTATION ARE REQUIRED FOR FILING PURPOSES. <br />APPLICABLE FEES MUST BE PAID AT THE TIME OF FILING AN ENVIRONMENTAL DOCUMENT WITH <br />THE ALAMEDA COUNTY CLERK'S OFFICE. <br />MAKE CHECK PAYABLE TO: ALAMEDA COUNTY CLERK <br />Rev. 1/15/91-1056C <br />g:~a-forms~cega~filing.cvr <br />