632 S.Sonya Pl.
.~
Anaheim Union High School District
501 Crescent Way, P.O~ Box 3520, Anaheim, CA 92803-3520
(714) 999-2188
(714) 520-5741 FAX
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
NOTICE: The gO-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 YOlf
have received the requisite notice, the gO-day protest period began at the time your project was approved.
High School District:
Anaheim Union High School District
Receipt No:
Owner Information:
Name:
Address:
Phone Number:
"d0L.J
Applicant Information:
Name:
Phone Number: (
~""-'<z.-
~~-'
Property Information:
Address of Project:
Development Type:
Project Name:
Type: [
~ .
~UL /[s.vI 42/~
] Residential - New [ ;b Residential - Room ,Addition
"',
] Commercial
] Single Family
Multi-Family Condos/Apartments - # of units:
Commercial:
Total Square Footage:
Multiplied by Current Rate: Elem. $
H.S. $
Equals Total Fee: $
-$
~$
- $
Residential:
[ ] Level 1 [ ] Level 2 . ACSO Only d1;[ ] Level 3. AC50 Only
./' &'
Total Square Footage: G> 7/
Multiplied by Current Rate: Elem. $ /J ~- $,:J;;/.;s. .7'
H.S. $)/?-'-$30/.(;l.Z
Equals Total Fee: $ -'1 ,;< >L - $" 6-R7.
"4 I
Fee Waiver:
Fees Waived:
Yes
No
If yes, reason:
Acknowledgement:
The above representations as to square footage are true. Developer/Applicant agrees that if it is later determined that such
representations are not true, Certificate shall automatically terminate and the appropriate City/County shall be notified.
Developer/Applicant Signature: ~Y\JI\.D 'I"'" . ~ -.e~
Certification:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code
Sections 53080 and 65995.
IlJ /1';/:5-
Date /
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Union High School District
Actual,!<~s. Pl!!~:
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Check No.
Check No.
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Anaheim Union H.5. District
Distribution: City/County - Developer - Accounting . Elementary District
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