Laserfiche WebLink
*ENVIRONMENTAL DECLARATION <br />(CALIFORNIA FISH AND GAME CODE SEC. 711.4) <br />FOR COwTM <br />ME AND ADDRESS OF APPLICANT OR LEAD AGENCY: <br />LING REQUESTED BY: s t p- <br />City of San Leandro <br />Development Services Department PATRICK O"UNMU, Nutdyq*k <br />835 East le Street B Y <br />San Leandro, CA 94577 <br />WHEN FILED RETURN TO: FILING NO. 2 i - O/ <br />City of San Leandro <br />City Clerk <br />835 East 14th Street <br />San Leandro, CA 94577 <br />CLERK'S <br />CLASSIFICATION OF ENVIRONMENTAL DOCUMENT: USE ONLY <br />1. NOTICE OF EXEMPTION/STATEMENT OF EXEMPTION PLU 117 <br />[ ] A- STATUTORILY OR CATEGORICALLY EXEMPT <br />$25.00 (Twenty-five Dollars) - CLERK'S FEE <br />[ ] B - DE MINIMUS IMPACT (GOVERNMENT 3 27383) PLU 117 <br />CERTIFICATE OF FEE EXEMPTION REQUIRED <br />$25.00 (Twenty-five Dollars) - CLERK'S FEE <br />2. NOTICE OF DETERMINATION - FEE REQUIRED PLU 116 <br />[ ] A - 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 IMPACT REPORT PLU 115 <br />$850.00 (Eight Hundred Fifty Dollars) - STATE FILING FEE <br />$25.00 (Twenty-five Dollars) - CLERKS FEE <br />3. X OTHER (Specify) kll e "Ije4A jW14ayl -,io I- AN 200/ - 00019 PLU 117 <br />$25.00 (Twenty-five Dollars) -CLERICS FEE WH.S.k/ 4 4-mt 5f� S d 1 1, Drl <br />47 <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 <br />[TH THE ALAMEDA COUNTY CLERK'S OFFICE. <br />MAKE CHECK PAYABLE TO: ALAMEDA COUNTY CLERK <br />Rev. 1/15/91-1056C gAa-fomns\aega\81ing.cvr r40"'q U 7/oI <br />