140 W VALENCIA AVE BAnaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714) 999-5454
CERTIFICATE of COMPLIANCE
PAYMENT Of SCHOOL FACILITY FEES
NOTICE: The 90-day period in which you may protest the fee described herein will begin on the date this fee is paid. However, if the fee was
imposed by the City or County as a condition of approval for your project, and you have received the requisite notice, the 90-day protest period
began at the time your project was approved. Returned checks (NSF) are subject to a 1 $30.00 administrative Fee.
RECEIPT NO.: ELEMENTARY DISTRICT: HIGH SCHOOL DISTRICT:
1 / 54� Anaheim Elementary
l0 school District (AESD) Anaheim Union High School District (AUESD)KA
OWNER INFORMATION:
Name: Marco Fernandez
Address: 140 W. Valencia Ave Anaheim CA 92805
Phone Number: Home( )
Cell (714) 19-67 2
APPLICANT INFORMATION:
3 Name: Karen Fernandez
Phone Number: Home ( )
Cell (714) 328-8390
PROPERTY INFORMATION:
Project Address: 140 W VALENCIA #B, ANAHEIM, CA
4 Development Type: ( AVE.,� P yp X) Residential -New
( }Residential -Room Addition ( )Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments # of units:
Project Name: 24-02202 ATT GC ADU
COMMERCIAL:
Total Square Footage:
Multipiled by Current Rate
5 Elem. $ _$
Equals Tota ; $ _ $
IFEE WAIVER:
6 Fees Waived: ( ) Yes
(X) No if yes, reason:
ACKNOWLEDGEMENT:
:SIDENTIAL:
Total Square Footage: 371
Multipiled by Current Rate
Elem. $ 2.585=$ 959.4
H.S. $ 2.395 =$ 888.55
Equals Total fee: = $ j �
The above respresentations as to square footage are true, Developer/Applicant agrees that if it is later determined that such respresentations
7 are not true, Certificate shall automatically terminate and the appropriate City/County shall be notified.
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995,
8/30/Z-;
Date
Representative - Anaheim Union High School District
ACTUAL FEES PAID:
1.Anaheim Elementary $ 959.04 Check No. 05 D003o400-7
9 School District (AESD) $ 888.55
2.Anaheim Union H.S. Dist. �� Check No. t05 000304 )6CO
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department
=1.2 ss
.-- . I —err ; -_ —