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L, Fee deferral Schedule If the project's on-site air pollution reductions(mitigation measure)insufficiently reduced air pollution as outlined in Rule 9510,an off-site fee is assessed based on the excess air pollution, The moneys collected from this fee will be used by the District to reduce:fir pollution emissions'off-site'on behalf of the project. Au Applicant may request a deferral of all or part of flee'offsite' tees up to,but not to exceed,the start date of construction. The;start of construction is aryl of the following,whichever ucecurs first:start of grading,start of demolition,or any other site development activities not mentioned above. C I request a Fee Deferral Schedule,and have enclosed the Fee Deferral Schedule Application. Fhe 1:ee Dcitrral SQhQdu!e :Application,can be: found on the JXislri•:t'a%wbl ile at tvtia4v cttllu aiu:ort'. M. Change of Project Developer The Applicant assumes all responsibility for ISR cotupliance for this project. If the project developer changes,the Applicant must notify the Buyer,and both Buyer and Applicant must file a`Change of project Developer'form with the District. If there is a change of project developer,and a`Change of Pri jl ct Developer'form is not tiled with the District,the Applicant will reinitin liable for ISR compliance. 1•hc t'lliltlut'of'Pr<7jcJt OQ2 efoper[c;'rn C;w lu: }ountl on Ilie DiStrivt'>,e4t ;,te at ww%V.Vallewkir:r rru: N. Attachments Required, If applicable: 1f9 Tract Map or Project Design Map ❑Letter from Applicant granting Agent authorization ®"vicinity Map ❑rec Deferral Schedule Application Application riling fee ❑Monitoring&Reporting Schedule S841.00 for mixed use:and non-residential projects OR Supporting documentation for selected Mitigation Measures $562.00 for residential projects only d. Certificatlon Statement I certify that I have reviewed and completed the entire application and hereby attest that the information relayed within is true and correct to the best of my knowledge,: I commit to implementation of those on-site mitigation measures that I have selected above. 1 am responsible for notifying the District if I will be unable to ilslpleement these mitigation measures, If a committed mitigation measure is not implemented,the project may be re-assessed for air quality impacts, (An authorized Agent may sign the form in lieu of the Applicant if an authorization letter signed by the Applicant is provided). ivame(printed): Il0 SAN Title: CJtr��/ Signature: Date; 0241 L,17-02A) Central Region Office: 1990 E.Gettysburg Ave.Fresno,CA 93726-0244 TEL(559)230-6000 FAX(559)230.6061 WEB tir.:rr.yallcv,ir:nre Page 4 of 12 Residential/Non-ResidenliellMixed-Use Application For n Revised June 28,2019