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HomeMy WebLinkAboutAD 04-07; Sperberg Addition; Administrative Permits (ADMIN)CITY OF CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CHECK BOXES) (FOR DEPARTMENT f USE ONLY) 7>Administrative Permit J^ i * Administrative Variance Coastal Development Permit Conditional Use Permit J^Kcondominium Permit i Environmental Impact Assessment General Plan Amendment Hillside Development Permit Local Coastal Program Amendment Master Plan Non-Residential Planned Development Planned Development Permit bttirvcn D D E Planned Industrial Permit Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Permit Specific Plan Tontativo Parcel Map Obtain from Engineering Department Tentative Tract Map Variance Zone Change List other applications not (FOR DEPARTMENT USE ONLY) 2) ASSESSOR PARCEL NO(S).: 3) PROJECT NAME: 4) BRIEF DESCRIPTION OF PROJECT:0 «*TO U\MWfe 5) OWNER NAME tPrint or Type)6) APPLICANT NAME (Print or Type) K£>Kf5Th A . PU^DY MAILING ADDRESS MAILING ADDRESS cr- CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNATURE 1 CERTIFY THAT 1 AM THE LEGAL REPRESENTATIVE OF THE OWNER^ttlD THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRBKT THE BEST OF MY KNOWLEDGE. DATE DATE 7) BRIEF LEGAL DESCRIPTION NOTE: A PROPOSED PROJECT REQUIRING MUtTtPfcE APPUCATfGNS BI FILED, MUST BE SUBMinED PRIOJR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY OWE APPUCATIOfil BE FJUE0, MUST BE SUBMITT€0 PRIOR TO 4:00 P.M. Form 14 Rev. 04/04 PAGE 1 OF 6 ,9 8)LOCATION OF PROJECT: ON THE BETWEEN (NORTH, SOUTH, EAST, WEST) (NAME OF STREET) STREET ADDRESS SIDE OF AND (NAME OF STREET) 9) LOCAL FACILITIES MANAGEMENT ZONE 10) PROPOSED NUMBER OF LOTS 16 1 3) TYPE OF SUBDIVISION 1 6) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 1 9) GROSS SITE ACREAGE 22) EXISTING ZONING 11) NUMBER OF EXISTING RESIDENTIAL UNITS 14) PROPOSED IND OFFICE/ SQUARE FOOTAGE 17) PROPOSED INCREASE IN ADT 20) EXISTING GENERAL PLAN 23) PROPOSED ZONING 7. w (NAME OF STREET) 12) PROPOSED NUMBER OF RESIDENTIAL UNITS 15) PROPOSED COMM SQUARE FOOTAGE 18) PROPOSED SEWER USAGE IN EDU 21) PROPOSED GENERAL PLAN DESIGNATION SL 24)IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS, DESIGN REVIEW BOARD MEMBERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT TO ENTRY FOR THIS.PURPOSE FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE FEE REQUIRED RECEIVED JUL 1 k 20(W CITY OF CARLSBAD DATE El VED TOTAL FEE REQUIRED RECEIVEJ^PY:, Form 14 Rev. 04/04 PAGE 2 OF 6 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: PURDY, KENNETH Description AD040007 Amount 256.66 Receipt Number: R0043738 Transaction Date: 07/14/2004 Pay Type Method Description Amount Payment Check 3085 256.66 Transaction Amount: 256.66 6564 07/14/04 0002 01 02 CGF" 256 ..66 PROJECT DESCRIPTION/EXPLANATION PROJECT NAME: APPLICANT NAME: KgK)KtgT>V Please describe fully the proposed project by application type. Include any details necessary to adequately explain the scope and/or operation of the proposed project. You may also include any background information and supporting statements regarding the reasons for, or appropriateness of, the application. Use an addendum sheet if necessary. Description/Explanation: The existing condominium residential unit includes a rear second floor covered patio. The owners are proposing to wall in the two open sides of the patio to expand interior living space. Other units adjacent to this property have already expanded in the same way. c City of Carlsbad Planning Department DISCLOSURE STATEMENT Applicant's statement or disclosure of certain ownership interests on all applications which will require discretionary action on the part of the City Council or any appointed Board, Commission or Committee. The following information MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this information is completed. Please print. Note: Person Is rfefneci as *Any fndMcfuat, %mt copartnership, Joint venture, association, soetal dute, corporation, estate, trust, receiver, syndicate, 'm Ms and any other eoanfy>, city and county, cfty munfefpattty, district or other political subdivision or any ofter group or combination acting as a unit* Agents may sign this document; however, the iegal name and entity of-the applicant and property owner must be provided below, 1. APPLICANT (Not the applicant's agent) Provide the COMPLETE. LEGAL names and addresses of ALL persons having a financial interest in the application. If the applicant includes a corporation or partnership, include the names, title, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publiclv-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Corp/PartPerson, Title Title Address Address 2. OWNER (Not the owner's agent) Provide the COMPLETE. LEGAL names and addresses of ALL persons having any ownership interest in the property involved. Also, provide the nature of the legal ownership (i.e, partnership, tenants in common, non-profit, corporation, etc.). If the ownership includes a corporation or partnership, include the names, title, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publiclv-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person_ Title Address Corp/Part. Title md Address » ^ 1635 Faraday Avenue • Carlsbad. CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us c 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, list the names and addresses of ANY person serving as an officer or director of the non-profit organization or as trustee or beneficiary of the. Non Profit/Trust oa yW<*f M*-^ (\H KVSTNon Profit/Trust, Title Address, 4. Have you had more than $250 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? Yes No If yes, please indicate person(s):_ NOTE: Attach additional sheets if necessary. I certify that all the above information is true and correct to the best of my knowledge. 1 Signature of owner/$ate/ Signature of applicant/date Print or type name of owner . . Print or type name of applicant Signature of owner/applicant's agent if applicable/date Print or type name of owner/applicant's agent H:ADMIN\COUNTER\DISCLOSURE STATEMENT 5/98 Page 2 Of 2 Jul 23 04 02:35P K ^PURDY HRCHITECT 17606325269 p.2 Sherrill Condominium Homeowners Association My 1,2004 Mr. And Mrs. Richard T. Sperberg 6823 El Fuerte Street Carlsbad, CA 92009 Upon reviewing the plans submitted for your remodeling project, the association has decided to approve your plans. Sincerely, Anne Cannova Treasurer Sherrill Condominium Homeowners Association AC/ds Attachment: Sherrill Condominium Homeowners Association Minutes, dated December 10,2003 Jul 23 04 02:36p K R PURDY HRCHITECT 17606325269 P-3 f^ <*"*». SHHRR11,1, CONDOMINIUM HOMEOWNERS ASSOCIATION DECEMBER 10, 2003 A meeting of the Sherrill Condominium Homeowners Association was held at 6829 El Fuerte Street on December 10, 2003. Those present were Anne Cannova, David Sillner, Rich Sperbcrg, and Myron and Lydia Svvi/e. The meeting was called to order at 7:00 P.M. by Rich Sperberg, President. David Sittner arrived at 7:20 P.M. Anne Cannova presented the Treasurer's Report: $797.78 in the checking account and $7,029.61 in the savings account. A bill from the plumber for $713.00 to install a back-flow control for the irrigation system is yet to be paid. The minutes from the meeting on August 19, 1999 were reviewed and approved. One item of old business was discussed: Roofing Needs Repairs have been made to the roofs of the units at 6829, 6827, and 6823 El Fuerte Street, by Sylverier Roofing Company, Inc., of Escondido. Discussion was held regarding the cost-effectiveness of continuing to make costly interim roof repairs when roof replacement is needed. There was considerable discussion about the feasibility of replacing both roofs within the next three years. The discussion focused primarily on ways to fund the reroofing. Options considered were (1) saving the money, through an increase in the homeowners association fee, adjusted to make the savings possible within the three years, (2) creating a special assessment of each homeowner for the amount needed to fund the replacement of rool"s, (3) borrowing the money as a homeowners association and then repaying the loan, or (4) some combination of the options one through three. During the discussion David expressed a preference for a special assessment for funding, Myron preferred raising the monthly fees incrementally to cover the cost, as did Anne, and Rich agreed that a monthly fee increase could reduce the need for a special assessment. David expressed the opinion that we should replace the roofs now. He agreed to obtain several bids, including a comparison of cost between roof installation in different times of the year (rainy vs. dry season). Anne agreed to talk to bank officials about the possibility of the Association obtaining a loan. Three items of new business were discussed: I. Sperbergs' Remodel Rich explained the scope and plan for the remodel of their upstairs deck to incorporate it into the existing rooms of their unit. There was support for the planned remodeling. II. Dissolving the Homeowners Association David suggested that we consider separating the four units out of a condominium association. After considerable discussion about responsibility for maintenance, costs, etc., David agreed to research the concept, identify what would be required legally and the costs, and bring a proposal to the next meeting. Rich expressed a concern that any proposal include equitable treatment to all units regarding the need for roofs. Jul 23 04 02:36P K H FURDY RRCHITECT 17606325E69 P-4 III. Termite work There is confusion about the nature and extent of any termite problem. Rich will ask his brother- in-law, who works in the field, to assess our situation. The members of the Association agreed lo meet again sewn to consider information and/or proposals regarding roofing, possible termite damage, and dissolving the condominium association. Officers were reappointed for that interim period, until the next meeting, and Anne asked that someone else consider the office of Treasurer after that time, David requested that all members receive a copy of any request for fees or work as soon as those requests are received. It was agreed thai would occur. The meeting adjourned at 8:30 P.M. 09 346 361 r /z 2* CONDM: SHERRILL - PAR. A 8, PAR. B PM. 6619 DOC. 78-50955 3* CONDM LA COSTA, PAR I PM 10081DOC8O-307I57 4* CONDM: PAR I OF PM 10840 DOC8HO0404I 5* CONDM.PARCEL A PM. 10352 DOC 81-023113 6* CONDM. LA COSTA . DOC.SI-190879 7* CONDM LA COSTA VIEW HIDOC 82-373740 8* CONDM PAR. A PM 13744DOC 85-121219 9* CONDM PAR I PM 13796DOC 85-177471 10* CONDM. 2845-2847 CAZADERO DR DOC9I-48O029 PAR I PM 14671 11* CONDO LA COSTA HILLS DOCS81-237275,84-136340 & 97-202229 LOT 1 MAP 10132 12* CONDO 6844 & 6846 URUBU STREETDOC03-1235257 LOT 320, MAP 6905 215-34 11/26/03 M.O. THIS MAP WAS PREPARED FOR ASSESSMENT PURPOSES ONLY. NO LIABILITY 6 ASSUMED FOR THE ACCURACY OF THE DATA SHOWN. ASSESSOR'S PARCELS MAY NOT COMPLY WfTH LOCAL SUBDIVISION OR BUIONG ORDWNCES. SAN OIEGO COUNTY ASSESSOR'S MAP BK 2I5 PG 34 I* CONDM NOTE: EACH SUB ID INCLUDES AN UNO 1/2 INT IN COMMON AREA WITHIN ITS RESPECTIVE PARCEL MAP 10132-CARLSBAD TCT NO. 8O2 (CONDM) MAP 6905 - LA COSTA MEADOWS UNIT NO. 2 - LOTS 311-317,320-341, 362-366 & 399-401 cCity of Carlsbad Planning Department August 12, 2004 Kenneth Purdy 2017PintorescoCt Carlsbad, CA 92009 SUBJECT: AD 04-07 - SPERBERG ADDITION Thank you for applying for Land Use Permits in the City of Carlsbad. The Planning Department has reviewed your Administrative Permit, application no. AD 04-07, as to its completeness for processing. ,; The application is complete, as submitted. Although the initial processing of your application may have already begun, the technical acceptance date is acknowledged by the date of this communication. The City may, in the course of processing the application, request that you clarify, amplify, correct, or otherwise, supplement the basic information required for .the application. In addition, you should also be aware that various design issues may exist. These issues must be addressed before this application can be scheduled for a hearing. The Planning Department will begin processing your application as of the date of this communication. At this time, the City asks that you provide one complete set of the development plans so that the project can continue to be reviewed. Please contact your staff planner, Mike Strong, at (760) 602-4625, if you have any questions or wish to set up a meeting to discuss the application. Sincerely, MICHAEL J7HOI Planning Director MJH:MS:bd c: Chris DeCerbo Jeremy Riddle File Copy Data Entry Planning Aide 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us City of Carlsbad Planning Department August 24, 2004 Kenneth A. Purdy 2017 PintorescoCt Carlsbad, CA 92009 SUBJECT: ADMINISTRATIVE PERMIT NO. AD 04-07 - SPERBERG ADDITION - ADMINISTRATIVE AMENDMENT TO A CONDOMINIUM PERMIT - Request to construct a 320 square foot second-story addition at 6823 El Fuerte, in the R-2 Zone and Local Facilities Management Zone 6. APN: 215-340-39-03 Dear Mr. Purdy: The Planning Director has completed a review of your application for an Administrative Amendment to a condominium permit to allow a 320 square foot second-story addition at 6823 El Fuerte. After careful consideration of this request including written and verbal comments and objections from surrounding property owners, if any, the Planning Director has determined that the findings required for granting an Administrative Permit for the proposed addition can be made and, therefore, APPROVES this request based on the following findings and conditions: Findings 1. That the proposed addition complies with the standard setback requirements of the Planned Development Ordinance with at least a 5 foot side yard setback and a 10 foot rear yard setback. 2. A minimum 15' x 15' rear yard area is maintained. 3. The lot coverage does not exceed 50% of the net lot square footage. 4. The proposed addition is architecturally compatible with the existing residence. 5. That the owner has received approval for the addition from the Architectural Committee and Board of Directors for Sherrill Condominium Homeowners Association. 6. That the Planning Director has determined that the project belongs to a class of projects that the State Secretary for Resources has found do not have a significant impact on the environment, and it is therefore categorically exempt from the requirement for the preparation of environmental documents pursuant to Section 15301 of the state CEQA Guidelines. In making this determination, the Planning Director has found that the exceptions listed in Section 15300.2 of the state CEQA Guidelines do not apply to this project. 7. That all necessary public improvements have been provided. 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us C 3 AD 04-07 - SPERBERG ADDITION August 25, 2004 Page 2 8. The project is consistent with the City-Wide Facilities and Improvements Plan, the Local Facilities Management Plan for Zone 6 and all City public facility policies and ordinances. The project includes elements or has been conditioned to construct or provide funding to ensure that all facilities and improvements regarding: sewer collection and treatment; water; drainage; circulation; fire; schools; parks and other recreational facilities; libraries; government administrative facilities; and open space, related to the project will be installed to serve new development prior to or concurrent with need. a. The project has been conditioned to provide proof from the San Marcos Unified School District that the project has satisfied its obligation for school facilities. b. The Public Facility fee is required to be paid by Council Policy No. 17 and will be collected prior to the issuance of building permit. 9. That the proposed project is compatible with the surrounding future land uses since they are designated for residential development on the General Plan. 10. The Planning Director has reviewed each of the exactions imposed on the Developer contained in this resolution, and hereby finds, in this case, that the exactions are imposed to mitigate impacts caused by or reasonably related to the project, and the extent and the degree of the exaction is in rough proportionality to the impact caused by the project. Conditions of Approval 1. If any of the following conditions fail to occur, or if they are, by their terms to be implemented and maintained over time, if any such conditions fail to be so implemented and maintained according to their terms, the City shall have the right to revoke or modify all approvals herein granted, deny or further condition issuance of all future building permits, deny, revoke, or further condition all certificates of occupancy issued under the authority of approvals herein granted, institute and prosecute litigation to compel their compliance with said conditions or seek damages for their violation. No vested rights are gained by Developer or successor in interest by the City's approval of this Administrative Amendment to Condominium Permit. 2. Staff is authorized and directed to make, or require the Developer to make, all corrections and modifications to the AD 04-07 documents, as necessary to make them internally consistent and in conformity with the final action on the project. Development shall occur substantially as shown on the approved Exhibits. Any proposed development different from this approval shall require an amendment to this approval. 3. The Planning Director does hereby APPROVE the ADMINISTRATIVE PERMIT for the project entitled "SPERBERG ADDITION," Exhibits A-C, dated August 24, 2004, on file in the Planning Department and incorporated by this reference), subject to the conditions herein set forth. Development shall occur substantially as shown on the approved Exhibits. Any proposed development substantially different from this approval, shall require an amendment to this approval. 4. The Developer shall comply with all applicable provisions of federal, state, and local ordinances in effect at the time of building permit issuance. AD 04-07 - SPERBERG ADDITION August 25, 2004 PageS 5. Prior to the issuance of a building permit, the Developer shall provide proof to the Director from the School District that this project has satisfied its obligation to provide school facilities. 6. If any condition for construction of any public improvements or facilities, or the payment of any fees in-lieu thereof, imposed by this approval or imposed by law on this residential housing project are challenged this approval shall be suspended as provided in Government Code Section 66020. If any such condition is determined to be invalid this approval shall be invalid unless the City Council determines that the project without the condition complies with all requirements of law. 7. This approval shall become null and void if building permits are not issued for this project within 18 months from the date of project approval. 8. The Developer/Operator shall and does hereby agree to indemnify, protect, defend and hold harmless the City of Carlsbad, its Council members, officers, employees, agents, and representatives, from and against any and all liabilities, losses, damages, demands, claims and costs, including court costs and attorney's fees incurred by the City arising, directly or indirectly, from (a) City's approval and issuance of this Administrative Permit to a Condominium Amendment, (b) City's approval or issuance of any permit or action, whether discretionary or non-discretionary, in connection with the use contemplated herein, and (c) Developer/Operator's installation and operation of the facility permitted hereby, including without limitation, any and all liabilities arising from the emission by the facility of electromagnetic fields or other energy waves or emissions. 9. This project shall comply with all conditions and mitigation measures, which are required as part of the Zone 6 Local Facilities Management Plan and any amendments made to that Plan prior to the issuance of building permits. Code Reminder 10. Approval of this request shall not excuse compliance with all applicable sections of the Zoning Ordinance and all other applicable City ordinances in effect at time of building permit issuance, except as otherwise specifically provided herein. NOTICE Please take NOTICE that approval of your project includes the "imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to for convenience as "fees/exactions." You have 90 days from August 24, 2004 to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedure set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity charges, nor planning, zoning, grading or other similar application processing or service fees in connection with this AD 04-07 - SPERBERG ADDITION August 25, 2004 Page 4 project; NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. This decision may be appealed by you or any other member of the public to the Planning Commission within ten days of the date of this letter. Appeals must be submitted in writing to the Planning Department at 1635 Faraday Avenue in Carlsbad, along with a payment of $400.00. The filing of such appeal within such time limit shall stay the effective date of the order of the Planning Director until such time as a final decision on the appeal is reached. If you have any questions regarding this matter, please feel free to contact Mike Strong at (760) 602-4625. City of Carlsbad DON NEU, Assistant Planning Director DN:MS:bd c: Michael Holzmiller Chris DeCerbo Jeremy Riddle File Data Entry c o FILE COPY City of Carlsbad Planning Department NOTICE OF REQUEST FOR AN ADMINISTRATIVE AMENDMENT TO A PLANNED DEVELOPMENT PERMIT Notice is hereby given that an Administrative Amendment to a Planned Development Permit has been applied for to allow a 320 square foot second story addition on the property generally located at: 6823 El Fuerte Street Carlsbad, California 92009 Assessors Parcel No. 215-340-39-03 If you have any objections to the granting of this permit or wish to have an informal hearing to discuss the requested permit, please notify the Planning Department, 1635 Faraday Avenue, Carlsbad, California 92008, in writing within 10 days of the date of this notice. If you have any questions, please call Greg Fisher in the Planning Department at 602-4629. CASE NO.:AD 04-07 CASE NAME: SPERBERG ADDITION DATE:July 26, 2004 CITY OF CARLSBAD PLANNING DEPARTMENT 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us NOTICE OF EXEMPTION To: Office of Planning and Research From: CITY OF CARLSBAD P.O. Box 3044 Planning Department Sacramento, CA 95812 1635 Faraday AvenueIF 0 D= HI c§sbad'CA X008 County Clerk Gregoiy J. Smith, Recordef/Countftfift) 602-4600' County of San Diego .... 4, _ Attn: Karen Hernandez, Room 260 "ft 1600 Pacific Highway San Diego, CA 92101 DEPUTY Subject: Filing of this Notice of Exemption is in compliance with Section 21152$x>fJgi§^Public Resources Code (California Environmental Quality Act). Project Title: AD 04-07 - SPERBERG ADDITION Project Location - Specific; 6823 El Fuerte Project Location - City; Carlsbad Project Location - County: San Diego Description of Project: Administrative Amendment to expand living area in a condominium unit Name of Public Agency Approving Project; City of Carlsbad Name of Person or Agency Carrying Out Project; Kenneth A. Purdy Name of Applicant; Kenneth A. Purdy Applicant's Address; 2017 Pinteresco Ct Applicant's Telephone Number; 760-438-3488 Exempt Status: (Check One) Ministerial (Section 21080(b)(l); 15268); Declared Emergency (Section 21080(b)(3); i5269(a)); Emergency Project (Section 21080(b)(4); 15269 (b)(c)); Categorical Exemption - State type and section number: Section 15301 Statutory Exemptions - State code number: Reasons why project is exempt: Existing facility Lead Agency Contact Person; Mike Strong Telephone; 760-602-4625 MICHAEL J. HOLZMIBKER, Planning fifrEftdfcf T^r OF;r> (>" Tut- rc.,.,,,-.. . J ., Date --"fVTnr - J ^"i~ -~-J^"J'^' ' ---PK'•>•• u^nj .(/-.TV on Signed by Lead Agency -JS!,y 4(!G 2 7 ?/j/v Pomr f v -L p 9 7 Signed by Applicant .>r;.,,nc;,0 Revised March 2004 STATE OF CALIFORNIA - THE RESOURCES AGENCY DEPARTMENT OF FISH AND GAME ENVIRONMENTAL FILING FEE CASH RECEIPT DFG 753.5a (8-03) 248712 Lead Agency: (uountyJlState Agency of Filing: (MY of Corlshnd Date: (XO 04-01 5perb€rc77 Document No.: Project Applicant Name: ctProject Applicant Address: _ Project Applicant (check appropriate box): Local Public Agency [_J School District | | Others State Agency | | Private Entity CHECK APPLICABLE FEES: cial District ) Environmental Impact Report ) Negative Declaration ) Application Fee Water Diversion ) Projects Subject to Certified Reg County Administrative Fee ject that is exempt from fees Signature and title of person receiving payment: State Water Resou atory Programs cMo« rces Control Board rv^ei'O c $1.250.00 $ OnM $850.00 $ $850.00 $ $25.00 $ xJOTAL RECEIVED $ '-£' K) p^ WHITE-PROJECT APPLICANT YELLOW-DFG/FASB PINK-LEAD AGENCY GOLl 'ATE AGENCY OF FILING