Appendix D "Notice of Determination" - California

What Is Appendix D?

This is a legal form that was released by the California Governor's Office of Planning and Research - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2011;
  • The latest edition provided by the California Governor's Office of Planning and Research;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Appendix D by clicking the link below or browse more documents and templates provided by the California Governor's Office of Planning and Research.

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Download Appendix D "Notice of Determination" - California

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2.
Print Form
Notice of Determination
Appendix D
To:
From:
Office of Planning and Research
Public Agency: ___________________________
Address: ________________________________
U.S. Mail:
Street Address:
_______________________________________
P.O. Box 3044
1400 Tenth St., Rm 113
Contact: _________________________________
Sacramento, CA 95812-3044 Sacramento, CA 95814
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 Agency)
described project on _______________ 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 pursuant to the provisions of CEQA.
A Negative Declaration was prepared for this project pursuant to the provisions of CEQA.
3. Mitigation measures [
were
were not] made a condition of the approval of the project.
4. A mitigation reporting or monitoring plan [
was
was not] adopted for this project.
5. A statement of Overriding Considerations [
was
was not] 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 Received for filing at OPR: ____________________
Authority cited: Sections 21083, Public Resources Code.
Reference Section 21000-21174, Public Resources Code.
Revised 2011
2.
Print Form
Notice of Determination
Appendix D
To:
From:
Office of Planning and Research
Public Agency: ___________________________
Address: ________________________________
U.S. Mail:
Street Address:
_______________________________________
P.O. Box 3044
1400 Tenth St., Rm 113
Contact: _________________________________
Sacramento, CA 95812-3044 Sacramento, CA 95814
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 Agency)
described project on _______________ 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 pursuant to the provisions of CEQA.
A Negative Declaration was prepared for this project pursuant to the provisions of CEQA.
3. Mitigation measures [
were
were not] made a condition of the approval of the project.
4. A mitigation reporting or monitoring plan [
was
was not] adopted for this project.
5. A statement of Overriding Considerations [
was
was not] 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 Received for filing at OPR: ____________________
Authority cited: Sections 21083, Public Resources Code.
Reference Section 21000-21174, Public Resources Code.
Revised 2011