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e <br />*ENVIRONMENTAL DECLARATION <br />(CALIFORNIA FISH AND GAME CODE SECTION 711.4) <br />LEAD AGENCY NAME AND ADDRESS <br />City of San Leandro <br />Engineering & Transportation <br />835 E. 14th street <br />San Leandro, CA 94577 <br />FOR COUNTY CLERK USFfILL Vm sq, <br />ALAM5DA, COUNTY <br />MAR 0 7 2023 <br />MELISSA WINK, r�,'unty Clerk <br />gy : � ,_.- _90puty <br />FILE NO:��_ 00/ <br />CLASSIFICATION OF ENVIRONMENTAL DOCUMENT: <br />(PLEASE MARK ONLY ONE CLASSIFICATION) <br />1. NOTICE OF EXEMPTION / STATEMENT OF EXEMPTION <br />[XI A - STATUTORILY OR CATEGORICALLY EXEMPT <br />$ 50.00 - COUNTY CLERK HANDLING FEE <br />2. NOTICE OF DETERMINATION (NOD) <br />[ ] A - NEGATIVE DECLARATION (OR MITIGATED NEG. DEC.) <br />$ 2,764.00 - STATE FILING FEE <br />$ 50.00 - COUNTY CLERK HANDLING FEE <br />[ I B - ENVIRONMENTAL IMPACT REPORT (EIR) <br />$ 3,839.25 - STATE FILING FEE <br />$ 50.00 - COUNTY CLERK HANDLING FEE <br />3. OTHER: <br />***A COPY OF THIS FORM MUST BE COMPLETED AND SUBMITTED WITH EACH COPY OF AN <br />ENVIRONMENTAL DECLARATION BEING FILED WITH THE ALAMEDA COUNTY CLERK.*** <br />BY MAIL FILINGS: <br />PLEASE INCLUDE FIVE (5) COPIES OF ALL NECESSARY DOCUMENTS AND TWO (2) SELF-ADDRESSED <br />ENVELOPES. <br />IN PERSON FILINGS: <br />PLEASE INCLUDE FIVE (5) COPIES OF ALL NECESSARY DOCUMENTS AND ONE (1) SELF-ADDRESSED <br />ENVELOPES. <br />ALL APPLICABLE FEES MUST BE PAID AT THE TIME OF FILING. <br />FEES ARE EFFECTIVE JANUARY 1, 2023 <br />MAKE CHECKS PAYABLE TO: ALAMEDA COUNTY CLERK <br />