ATTACHMENT B
Statutory Exemptions. State code number:
_______________________________________________
Notice of Exemption Appendix E
From: (Public Agency): ____________________________To: Office of Planning and Research P.O. Box 3044, Room 113 _______________________________________________Sacramento, CA 95812-3044 County Clerk
(Address)
___________________________
___________________________
County of: __________________
Project Title: ____________________________________________________________________________ Project Applicant: ________________________________________________________________________ Project Location - Specific:
Project Location - City: ______________________ Project Location - County:
Description of Nature, Purpose and Beneficiaries of Project:
_____________________
Name of Public Agency Approving Project: _____________________________________________________ Name of Person or Agency Carrying Out Project: ________________________________________________ Exempt Status: (check one):
Ministerial (Sec. 21080(b)(1); 15268);
Declared Emergency (Sec. 21080(b)(3); 15269(a));
Emergency Project (Sec. 21080(b)(4); 15269(b)(c));
Reasons why project is exempt:
Lead Agency
Contact Person: ____________________________ Area Code/Telephone/Extension: _______________ If filed b
y applicant:
Attach certified document of exemption finding.
Has a Notice of Exemption been filed by the public agency approving the project? Yes No Signature: ____________________________ Date:
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Authority cited: Sections 21083 and 21110, Public Resources Code. Date Received for filing at OPR:
Reference: Sections 21108, 21152, and 21152.1, Public Resources Code. _______________
Categorical Exemption. State type and section number: ____________________________________ ______________________________________________
______________ Title: _______________________
Revised 2011
City of Victorville
14343 Civic Drive PO Box 5001
Victorville, CA 92393-5001
San Bernardino
385 North Arrowhead Avenue, Second Floor
San Bernardino, CA 92415-0130
Citywide Pavement Preservation and Maintenance Project
City of Victorville
Various locations - See attached Project Location Map
Victorville San Bernardino
Repair of asphalt pavement, crack-sealing, slurry sealing, micro-surfacing, and re-striping of existing roadways.
City of Victorville
City of Victorville
X Class 1 (15301c)
This project consists of maintenance and repair of existing roadways and re-striping for vehicle and pedestrian safety.
Fredy Bonilla, City Engineer (760) 955-5170
City Engineer
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