were not]
was not]
2. _______________________________________
_________________________________________
_______________________________________
___________________________________________________________________________________ Print Form
Notice of Determination Appendix D
To: From:
Office of Planning and Research Public Agency: ___________________________ Address: ________________________________U.S. Mail:
P.O. Box 3044
Sacramento, CA 95812-3044
Street Address:
1400 Tenth St., Rm 113
Sacramento, CA 95814
_______________________________________
Contact: _________________________________
Phone: __________________________________
County Clerk
Lead Agency (if different from above): County of: _________________________________ Address: __________________________________
Address: ________________________________
Contact: _________________________________
Phone: __________________________________
SUBJECT: Filing of Notice of Determination in compliance with Section 21108 or 21152 of the Public Resources Code.
State Clearinghouse Number (if submitted to State Clearinghouse):______________________________ Project Title: _________________________________________________________________________ Project Applicant: _____________________________________________________________________ Project Location (include county):_________________________________________________________ Project Description:
This is to advise that the ____________________________________________ has approved the above ( Lead Agency or Responsible A
gency)
described project o
n _______________ and has made the following determinations regarding the above (date)
described project.
1. The project [ will will not] have a significant effect on the environment.
2. An Environmental Impact Report was prepared for this project p ursuant to the provisions of CEQA.
A Negative Declar
ation was prepared for this project pursuant to the provisions of CEQA.
3. Mitigation measures [ were made a condition of the approval of the project.
4. A mitigation re
porting or monitoring plan [ was was not] adopted for this project.
5. A statement of Overriding Considerations [ was adopted for this project.
6. Findings
[ were were not] made pursuant to the provisions of CEQA.
This is to certify that the final EIR with comments and responses and record of project approval, or the negative Declaration, is available to the General Public at:
Signature (Public Agency): _____________________________ Title: ____________________________ Date: _______________________________ Date Recei
ved for filing at OPR: ____________________
Authority cited: Sections 21083, Public Resources Code.
Reference Section 21000-21174, Public Resources Code. Revised 2011 ATTACHMENT 3
A3-1