598 S SONYA ST, BAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
YOU o<>■
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 $30.00 administrative fee.
HIGH SCHOOL DISTRICT:
Anaheim Union High School District
ELEMENTARY DISTRICT:J^ECEIPTNO.:i£>bX\
OWNER INFORMATION:
Name:
g>g-Aygie7ty)VII <1^.V-.-
2 Address:
Ceil{Phone Number:Home
fAPPLICANT INFORMATION:)Name:3
Cell(Phone Number:Home(
PROPERTY INFORMATION:
Project Address:
Development Type:(*)Residential -New
{)Single Family
()Commercial:4 oc }Residential -Room Addition()Multi-Family Condos/Apartments #of units:
Project Name:
RESIDENTIAL:COMMERCIAL:
Total Square Footage:
3,2dS'.D^
Total Square Footage:
Muitipiled by Current RateMultipliedbyCurrentRate
AuHSD
Elem.
H.S.$
=$Elem.$_
H.S.$
5
=S V.75EqualsTotalFee:$=sEqualsTotalFee:$
FEE WAIVER:
Fees Waived:()Yes6 If yes,reason:(YiNo
\ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
^not true,Certificate shall automatically termi|nate and the appropriate City/County shall be notified.
Developer/Appllcant Signature;
7
%
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in complta^nce with Government Code Sections 53080 and
65995.
8
nion High School DistrictRepresentative-;^na mDate
ACTUAL FEES PAID:7^7s3,10^on
S
Check No.
Check No.9
Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department