CEQA Filing for ASA-2019-006 •
•
County of Santa Clara Santa Clara County-Clerk-Recorder Office
Office of the County Clerk-Recorder �' .c,, State of California
Business Division "Q 6'
rl,1r File Number: ENV22606
County Government Center 14, Gv,r�� ENVIRONMENTAL FILING
70 West Hedding Street, E.Wing, 1"Floor - No. of Pages: 2
San Jose,California 95110 (408)299-5688 Total Fees: $50.00
File Dateli: 02/07/2020
CEQA DOCUMENT DECLARATION Expires: 03/08/2020
ENVIRONMENTAL FILING FEE RECEIPT REGINA ALCOMENDRAS, Clerk-Recorder
By: Nina IKhamphilath, Deputy Clerk-Recorder
PLEASE COMPLETE THE FOLLOWING: . .
1. LEAD AGENCY: City of Cupertino
2. PROJECT TITLE: ASA-2019-006
3. APPLICANT NAME: Nathan Ung (19900 Stevens Creek Blvd, LLC) PHONE: 408-777-3308
4, APPLICANT ADDRESS: 19900 Stevens Creek Blvd Cupertino,Ca. 95014 •
5. PROJECT APPLICANT IS A: ❑Local Public Agency ❑School District ❑Other Special District CI.State Agency 0 Private Entity
6. NOTICE TO BE POSTED FOR 30 DAYS.
7.CLASSIFICATION OF ENVIRONMENTAL DOCUMENT
a.PROJECTS THAT ARE SUBJECT TO DFG FEES
❑ 1,ENVIRONMENTAL IMPACT REPORT(PUBLIC RESOURCES CODE§21152 $ 3,34325 $ 0.00
❑ 2.NEGATIVE DECLARATION (PUBLIC RESOURCES CODE§21080(C) $ 2,406.75 $ 0.00
❑ 3. APPLICATION FEE WATER DIVERSION(STATE WATER RESOURCES CONTRa. BOARD ONLY) $ 850.00 $ 0.00
in 4. PROJECTS SUBJECT TO CERTIFIED REGULATORY PROGRAMS $ 1,136.50 $ 0.00
a-4 ABOVE) $ 50.00 $ 0.00
FEE(REQUIRED FOR a-1 THROUGH
O 5. COUNTY ADMINISTRATIVE
Fish&Game Code§711.4(e)
b. PROJECTS THAT ARE EXEMPT FROM DFG FEES
In 1. NOTICE OF EXEMPTION($50.00 COUNTY ADMINISTRATIVE FEE REQUIRED) $ 50.00 $_ 50.00
In 2. A COMPLETED"CEQA FILING FEE NO EFFECT DETERMINATION FORM"FROM THE
DEPARTMENT OF FISH&GAME,DOCUMENTING THE DFG'S DETERMINATION THAT THE PROJECT
WILL HAVE NO EFFECT ON FISH,WILDLIFE AND HABITAT,OR AN OFFICIAL,DATED RECEIPT I
PROOF OF PAYMENT SHOWING PREVIOUS PAYMENT OF THE DFG FILING FEE FOR THE*SAME
PROJECT IS ATTACHED ($50.00 COUNTY ADMINISTRATIVE FEE REQUIRED)
DOCUMENT TYPE: 0 ENVIRONMENTAL IMPACT REPORT ❑NEGATIVE DECLARATION $ 50.00 $ 0.00
c. NOTICES THAT ARE NOT SUBJECT TO DFG FEES OR COUNTY ADMINISTRATIVE'FEES
❑ NOTICE OF PREPARATION ❑ NOTICE OF INTENT NO FEE $ NO FEE
8. OTHER: FEE(IF APPLICABLE): $
9. TOTAL RECEIVED $ 50.00
*NOTE:"SAME PROJECT MEANS NO CHANGES. IF THE DOCUMENT SUBMITTED IS NOT THE SAME(OTHER THAN DATES),A°NO EFFECT
DETERMINATION"LETTER FROM THE DEPARTMENT OF FISH AND GAME FOR THE SUBSEQUENT FILING OR THE APPROPRIATE FEES ARE
REQUIRED.
THIS FORM MUST BE COMPLETED AND ATTACHED TO THE FRONT OF ALL CEQA DOCUMENTS LISTED ABOVE(INCLUDING COPIES)
SUBMITTED FOR FILING. WE WILL NEED AN ORIGINAL(WET SIGNATURE)AND TWO(2)COPIES. IF THERE ARE ATTACHMENTS,PLEASE
PROVIDE THREE(3)SETS OF ATTACHMENTS FOR SUBMISSION. (YOUR ORIGINAL WILL BE RETURNED TO YOU AT THE TIME OF FILING.)
CHECKS FOR ALL FEES SHOULD BE MADE PAYABLE TO: SANTA CLARA COUNTY CLERK-RECORDER
PLEASE NOTE: FEES ARE ANNUALLY ADJUSTED(Fish&Game Code§711.4(b); PLEASE CHECK WITH THIS OFFICE AND THE DEPARTMENT
OF FISH AND GAME FOR THE LATEST FEE INFORMATION.
.NO PROJECT SHALL BE OPERATIVE, VESTED,OR FINAL,NOR SHALL LOCAL GOVERNMENT PERMITS FOR THE PROJECT BE VALID,
UNTIL THE FILING FEES REQUIRED PURSUANT TO THIS SECTION ARE PAID." Fish&Game Code§711.4(c)(3)
(Fees Effective 0141.2020)
CITY OF
COMMUNITY DEVELOPMENT DEPARTMENT
PLANNING DIVISION
CITY HALL
�0%1,4. 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
TELEPHONE: (408) 777-3308 • FAX: (408) 777-3333
CUPERTINO CUPERTINO.ORG
Notice of Exemption
To: County Clerk-Recorder
70 W. Hedding Street, 1st Floor
East Wing—Business Division
San Jose, CA 95110
Project Title: ASA-2019-006
Project Location- (be specific): 19900 Stevens Creek Blvd
Project Location- (City): Cupertino Project Location- (County): Santa Clara
Description of Project: Architectural and Site approval to allow site improvements at an
existing retail building
Name of Public Agency approving project: City of Cupertino
Name of Person or Agency carrying out project: Nathan Ung (19900 Stevens Creek Blvd, LLC)
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));
x Categorical Exemption. State type and section number: 15301
_Statutory Exemption. State code number:
Reasons why project is exempt: existing facilities
Lead Agency
Contact Person: Ellen Yau Area code/telephone number (408) 777-1360
Signature: C Date: I//6/,.7o.20 Title: Associate Planner