2672 W STONYBROOK DR (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
Or
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER INFORMATION:
Name;
Address:
Cell
2
<La ■V
Phone Number;Home ef2Ti4./^yyy9
APPUCANT INFORMATION:
Name:
Phone Number:Home{
»//'S-—^3
Cell
PROPERTY INFORMATION:
Project Address:
Development Type;()Residential -New Residential -Room Addition
()Single Family
4 (}Commercial:
()Multi-Family Condos/Apartments #of units:
Project Name:
RESIDENTIAL:COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate
5 Elei =S Eiem.S
H.S.S =$H.S.
^e:SEqualsT<=s Equals Total Fee:$=S
FEE WAIVER:
6 Fees Waived:()Yes No If yes,reason:
ACkNOWlEDGEMENt:^
The above respresentations as to square footage are true,Developer/Applicant^rees that if it is later determined that such respresentations
iriat&€jfy/County.sh5irae notified.7 are not true.Certificate shall automatically ten
Developer/Applicant Signature:0 CJ.
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Governmen'
65995.
ide Sections 53080 and
8 A.
Representa^Vev=..Af^heim Union High SchoolDate District
ACTUAL FEES PAID:rTyL^e-“S.Ti -$Anaheim Un^H.S.Dist.
Check No.
Check No.
9
$
Distribution:Developer/Appiicant,AUHSD Accounting Department,Elementary School District Accounting Department