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1363 S. State College Blvd. ~. Ananelm Union High School Di.strict 501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520 ~ (714) 999-2188 ~II (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 you have received the requisite notice, the gO-day protest period began at the time your project was approved. Receipt No; .;2.5"15 Owner Information: Name: Address: Phone Number: Elementary District: fb..~ . CiJ., 5'~/'o.1t High School District: Anaheim Union High School District /::k.1>'/ /'i'f '5 eN"! s.kk. ('o/&r- IjSrdc)...-!<-r UC PIa <-^H~ Ar< C. J'h. If1.,.Sa. ) :5(,(,- 0107:> Cf 926;) 7 Applicant Information: . Name: bl....... Phone Number: ( '7'11 Property Information: Address of Project: Development Type: Project Name: Type: Commercial: Total Square Footage: Multiplied by Current Rate: Equals Total Fee: Fee Waiver: Fees Waived: Yes $4';'" Colu.'}'- ) S&I!. - DID. A "DC;'" /-<.0 L-lC ''', \3b 3> .s. $-1....4.- C.1v<'Y- %Iv<l ] Residential - New [l Residential - RoomAddition Si-....\.<.. Coll.V- D~r;<;~ c..o.v-~ [Xl Commercial [ Single Family [ Multi-Family Condos/Apartments - # of units: \'\'140 Elem. $ .\ll H.S. $ , II> $ .~'" Residential: [ 1 Level 1 [ 1 Level 2 - ACSD Only Total Square Footage: Multiplied by Current Elem. $ H.S. $ $ = $ 3~.2.o = $ 3Sg'f.~ = $ 7/78:. "0 =$ =$ =$ [ ..r;;o If yes, reason: Nlk 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 omatically terminate and the appropriate City/County shall be notified. Developer/Applicant Signature: Certification: This certifies that the above named Developer/Applicant has paid schooi facility fees in compliance with Government Code Sections 53080 and 65995. ,hlo~ I Date Actual Fees Paid: Ii".. a'l >c"-Ir Anaheim Union H.S. District naheim Union High School District $ $ 3 5~q. 'Vi> 3'5 ~1. 2P 2(./6'1; Ug-q Check No. Check No. Distribution: Qt:j{County - Developer - ""counting ~ Elementary District ...~~-_.-.-.... PUBLIC WORKS DEPARTMENT FEES --TRAFFIC ENG,$EERING FEES-- BUILD # 2.Cl1OS' _oe>~\~ (13"V. q .. .. .... r/jtc? PROJECT SITE: t3> ~:sS .s+.....f" . CG\\~:;X: 1St.. , SIZE: Z. (;), '-4 ,,~~ \" '7 ~.::!.o SF It\( I) TRAFFIC SIGNAL FEES: '>')( 'Z.. '-/ ~ '::: 7 7..5' 279-412-F724-3017 , .~ X '=' r-' -= '7 ~ 0 ~RANSPORTATION IMP ACT AND IMPROVEMENT FEES: 278-412-F724-1818. "o~L\J< t.,. :.. ~7" . ~?C )('4~="3IS1 . 0 TRAFFIC SANTA ANA CANYON FEE: 278-412-F724-2001 TE# 30 o EASTERN TRANSPORTATION CORRIDOR FEE:. 101-412-F724-6704 Ov - I ,-{8~ . COMMENT: REVIEWED BY: ALFRED Y ALDA (714) 765-5183 i DATE: "\ 1\ ~l~ --DEV~LOPMENT SERVICES FEES-- RIGHT OF WAY REVIEWED BY DATE: o OLD ZONING CODE (i.e. in plan check or entitlement prior to July 8, 2004) IJI NEW ZONING CODE DEDICATION CREDIT ( ..'15 D.f'O! W10~ 0 l.J '^' /t>>S"t'OiJ ~ (')'77-00 ~ PILaJIOV) ~ ~f?:fl- (;Dr ~lf6 SlAetr g y r c \f<tl ~T (,...l E STREETIMPROVEMENTffiEPAlR SEWER CONNECTION FEE ACCT # CITY SEWER ASSESSMENT ACCT # DRAINAGE ASSESSMENT FEE ACCT # GRADING: WATER QUALITY MANAGEMENT PLAN (WQMP) LAND SUBDIVISION: REVIEWED BY: '--~-'_l /761 5' - e PUBLIC WORKS DEPARTMENT FEES --TRAFFIC ENGINEERING FEES-- BUlLD#2(.)o~- 6c/~\"'7 (3'-'1;).#/ PROJECT SITE: . SIZE: .. '" z."l ~ c>\=-~\ ~ ~ ,Z.?3. IN D I}rTRAFFIC SIGNAL FEES: .3)< 2,,1.\ ~ ~ 2- 279-412-F724-3017 9 >< ~ s :.Hs-r'"" _ TE# 2.' - - (It.. - gTRANSPORTATION IMPACT AND IMPRO~MENT FEES: 278-412-F724-1818 2. ~"3 X \ .to <:::: '"'t I "a..7 . . ~ , 2. '2.:; >s' Gl.4 '3 "" '3 S" l (.. o TRAFFIC SANTA ANA CANYON FEE: 278-412-F724-2001 o EASTERN TRANSPORTATION CORRIDOR FEE: 101-412-F724-6704 DATE: ~ -t~-o DEDICATION CREDIT STREET IMPROVEMENTIREP AIR SEWER CONNECTION FEE CITY SEWER ASSESSMENT ACCT # ACCT # DRAINAGE ASSESSMENT FEE ACCT # GRADING: WATER QUALITY MANAGEMENT PLAN (WQMP) LAND SUBDIVISION: REVIEWED QY: