HomeMy WebLinkAboutDRC2010-00336 Church DCAfRate of California —The Resources Agency
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010 ENVIRONMENTAL F..IING FEE CASH RECEIPT
:IPT# 390951
STATE CLEARING HOUSE #(Ifappficable)
LEADAGENCY DATE
h- I
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a;
7,29
PROJECT APPLICANT (Check appropriate box):
,J_ Local PublicAgency School District L3 Other Special District
L] State Agency
LJ Private Entity
CHECK APPLICABLE FEES:
LJ Environmental Impact Report (EIR)
$2,792.25
$
J Mitigated/Negative Declaration (ND)(MND)
$2,010.25
$
LJ Application Fee Water Diversion (State Water Resources Control Board Only)
$850.00
$
Projects Subject to Certified Regulatory Programs (CRP)
$949.50
$
County Administrative Fee
$50.00
$
�cn (Y—)
J Project that is exempt from fees
.�JlNotice of Exemption
Q DFG No Effect Determination (Form Attached)
Other
$
PAYMENT METHOD:
L] Cash LI Credit 4,,Check Other
TOTALRECEIVED
$
SIGNATURE
In -3
WHITE -PROJECT APPLICANT YELLOW - DFG/ASB PINK-LEADAGENCY GOLDEN ROD - COUNTYeLERK FG 753.5a (Rev. 11/09)
State of California —The ResourceS Aqency
DEPARTMENT OFFISH AN WE
2010 ENVIRONMENTAL FILING FEE CASH RECEIPT
RECEIPT# 390951
EARING HOUSE# (1fapplicable)
=LS& 111111111LIF MM1FWr—_AW,&-)1W
"I'll, P—W4120
PROJECT APPLICANT (Check appropriate box):
Local Public Agency L] School District L] Other Special District J State Agency L) Private Entity
CHI�CK APPLICABLE FEES:
L) Environmental Impact Report (EIR) $2,792.25 $
J Mitigated/Negative Declaration (ND)(MND) $2,010.25 $
L] Application Fee Water Dive rsion (State Water Resources Control Board Only) $850.00 $
L] Projects Subject to Certified Regulatory Programs (CRP) $949.50 $
County Administrative Fee $50.00 $
Project that is exempt from fees
.WNotice of Exemption
J DFG No Effect Determination (Form Attached)
J Other $
PAYMENT METHOD:
L] Cash L] Credit Check L] Other TOTALRECEIVED $ so
SIGNATURE TITLE
X j�p,�
WHITE -PROJECT APPLICANT YELLOW - DFG/ASB PINK-LEADAGENCY GOLDEN ROD - COLINTY'VLERK FG 753.5a (Rev. 11/09)
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