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*ENVIRONMENTAL DECLAMATION <br />(CALIFORNIA FISH AND GAME CODE SECTION 711.4) <br />LEAD AGENCY NAME AND ADDRESS I FOR COUNTY CLERK USE ONLY <br />City of San Leandro ENDORSED <br />FIBBED <br />Attn: Bennett Sanderson ALAMEDA COUNTY <br />Engineering & Transportation Department <br />835 E. 14th Street SEP 12 2023 <br />San Leandro, CA 94577 <br />ro2� O T�4ELI�41L�KGou�ntyQlerk <br />FILE NO: "uty <br />CLASSIFICATION OF ENVIRONMENTAL DOCUMENT: <br />(PLEASE MARK ONLY ONE CLASSIFICATION) <br />1. NOTICE OF EXEMPTION / STATEMENT OF EXEMPTION <br />[X] 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 />[ ] B -ENVIRONMENTAL IMPACT REPORT (EIR) I SFP <br />$ 3,839.25 - STATE FILING FEE <br />CITY CL�r; ; OFFICE <br />$ 50.00 - COUNTY CLERK HANDLING FEE �L'Lil. - <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 GEES W]UST BE PAID AT THE TIMUE OF FILING. <br />FEES ARE EFFECTIVE JANUARY 1, 2023 <br />MAKE CHECKS PAYABLE TO: ALAMEDA COUNTY CLERK <br />