State of California• Department of Fish and Wildlife
2024 ENVIRONMENTAL DOCUMENT FILING Fl':E
CASH RECEIPT
DFW 753.5a (REV. 01101/23) Previously DFG 753.Sa
SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY.
LEAD AGENCY LEADAGENCY EMAIL
PUBLIC WORKS AGENCY
COUNTY/STATE AGENCY OF FILING
jorange 18
PROJECT TITLE
ALLEY IMPROVEMENT PROGRAM (FY23-24)
I[ Print i llsf ovorll I Save
RECEIPT NUMBER:
30 - 02/29/2024 -0136
STATE CLEARINGHOUSE NUMBER /II applicable)
DATE
02/29/2024
DOCUMENT NUMBER
202485000138
PROJECT APPLICANT NAME PROJECT APPLICANT EMAIL PHONE NUMBER (714 )647-5665 CITY OF SANTA ANA, PUBLIC WORKS AGENCY
PROJECT APPLICANT ADDRESS
20 CIVIC CENTER PLAZA M-36
PROJECT APPLICANT (Check appropriate box)
[;;J Local Public Agency D School Distrtct
CHECK APPLICABLE FEES:
D Environmental Impact Report (EIR)
D Mitigated/Negative Declaration (MND)(ND)
CITY
SANTAANA
D Other Special District
D Cer1111ed Regulatory Program (CRP) document - payment due �lracUy to CDFW 0 Exempt from fee
0 Notice of Exemption (attach)
D CDFW No Effect DetennlnaUon (attach)
D Fee previously paid (allaoh provlously Issued cash receipt copy) D Water Right ApplloaUon or Pelillon Feo (State Water Resources Control Board only) D County documentary handling lee
D Other
PAYMENT METHOD:
STATE
CA
ZIP CODE
92702
D State Agency D Privale Entity
$4,051.25
$2,916.75
$1,377.25
$ 0.00 ----------
$ 0.00 ----------
$ -------�o=.o�o
$850.00 $ 0.00
$
$
D Cash D Credit D Chock D other TOT AL RECEIVED $ 0.00
SIGNATURE AGENCY OF FILING PRINTED NAME AND TITLE
X CARINA HERRERA, DEPUTY
ORIGINAl.•PROJECT APPI-/CANT COPY - CDFW/.ASB COPY - LEAD AGEN-CY COPY-COUNTYCLERK DFW 7.53.Sa (Rev. 01/01/2023) EXHIBIT 5