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6.C. - Page 6 of 11 <br />estate of California - Department of Fish and Wildlife <br />2019 ENVIRONMENTAL FILING FEE CASH RECEIPT <br />DFW 753.5a (REV. 12/01/18) Previously DFG 753.5a <br />Print 1 OVe i FinalizeBEmall <br />RECEIPT NUMBER: <br />41 — 06212019 — 1242 <br />STATE CLEARINGHOUSE NUMBER (lf applicable) <br />SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY. <br />LEADAGENCY LEADAGENCY EMAIL DATE <br />CITY OF REDWOOD CITY 06212019 <br />COUNTY/STATE AGENCY OF FILING DOCUMENT NUMBER <br />San Mateo 127570 <br />PROJECT TITLE <br />REDWOOD SHORES LIBRARY IMAGINATIVE ART PIRATE SHIP PROJECT <br />PROJECT APPLICANT NAME PROJECT APPLICANT EMAIL PHONE NUMBER <br />PROJECT APPLICANT ADDRESS CITY STATE ZIP CODE <br />PROJECT APPLICANT (Check appropriate box) <br />✓❑ Local Public Agency ❑ School District ❑ Other Special District Ej State Agency <br />Private Entity <br />CHECK APPLICABLE FEES: <br />❑ Environmental Impact Report (EIR) $3,271.00 $ <br />0.00 <br />❑ Mitigated/Negative Declaration (MND)(ND) $2,354.75 $ <br />0.00 <br />❑ Certified Regulatory Program (CRP) document - payment due directly to CDFW $1,112.00 $ <br />0.00 <br />I] Exempt from fee <br />I] Notice of Exemption (attach) <br />❑ CDFW No Effect Determination (attach) <br />❑ Fee previously paid (attach previously issued cash receipt copy) <br />❑ Water Right Application or Petition Fee (State Water Resources Control Board only) $850.00 $ <br />0.00 <br />El County documentary handling fee $ <br />50.00 <br />❑ Other $ <br />PAYMENT METHOD: <br />❑ Cash El Credit ❑ Check ❑ Other TOTAL RECEIVED $ <br />50.00 <br />SIGNATURE <br />AGENCY OF FILING PRINTED NAME AND TITLE <br />4,� <br />X <br />DIANA SIRON/ DEPUTY CLERK <br />ORIGINAL -PROJECT APPLICANT COPY - CDFW/ASB COPY - LEAD AGENCY COPY - COUNTY CLERK DFW 753.5a (Rev. 12012018) <br />91 <br />