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S.D. - Page 13 of 14 <br />State of California - Department of Fish and Wildlife <br />2020 ENVIRONMENTAL FILING FEE CASH RECEIPT <br />DFW 753.5a (REV. 12101119) Previously DFG 753.5a <br />SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY. <br />LEADAGENCY LEADAGENCY EMAIL <br />COUNTY/STATE AGENCY OF FILING <br />Alameda <br />rr[VJCV I I I I LC <br />MAJOR SUBDIVISION GRADING <br />t'NUJEG r APPLICANT NAME . <br />PROJECT APPLICANT ADDRESS <br />I <br />Printin= . . Finalize&EmailE <br />..-.._.A <br />RECEIPT NUMBER: <br />01— 01092020 — 1419 <br />ZnIAI t- CLEARINGHOUSE NUMBER (if applicable) <br />PROJECT APPLICANT EMAIL <br />CITY <br />F°KOJECT APPLICANT (Check appropriate box) <br />Q Local Public Agency ❑ School District ❑ Other Special District <br />CHECK APPLICABLE FEES: <br />❑ Environmental Impact Report (EIR) <br />ZI Mitigated/Negative Declaration (MND)(ND) <br />❑ Certified Regulatory Program (CRP) document - payment due directly to CDFW <br />❑ Exempt from fee <br />❑ Notice of Exemption (attach) <br />❑ CDFW No Effect Determination (attach) <br />❑ Fee previously paid (attach previously issued cash receipt copy) <br />IATE <br />01092020 <br />DOCUMENT NUMBER <br />127744 <br />PHONE NUMBER <br />;TATE ZIP CODE <br />❑ State Agency Private Entity <br />$3,343.25 $ C.00 <br />$2,406.75 $ 2,406.75 <br />$1,136.50 $ 0.00 <br />LJ . V -I -VI It : FJIJIFUCEEIUII UI rection r-ee ()late water Kesources Control Board only) 5850.00 $ 0.00 <br />m County documentary handling fee $ 5000 <br />❑ Other <br />PAYMENT METHOD: <br />❑ Cash ❑ Credit ❑ Check ❑ Other TOTAL RECEIVED $ 2,45675 <br />SIGNATURE AGENCY OF FILING PRINTED NAME AND TITLE <br />DIANA SIRON/ DEPUTY CLERK <br />ORIGINAL -PROJECT APPLICANT COPY-COFWlASB COPY - LEAD AGENCY COPY - COUNTY CLERK OFW 753,5a (Rev. 12012019 , <br />110 <br />