1615 W CHANTICLEER RD, BAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3
(714)999-5454
UNLIMITED
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1Ae
OWNER INEORMATION:
Name:
Address:j^(2
(7?yi 7/7-Phone Number:Home{Cell
APPLICANT INFORMATION:
3 Name:
CeWOlH)Phone Number:Home{
PROPERTY INFORMATION:
ChaProjectAddress:
Development Type:(Vi]Residential -New
()Single Family
mi(4 }Residential -Room Addition
{)Multi-Family Condos/Apartrnents#of units:
}Commercial:
Project Name:A'Dl^
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
5 Elem.$_=$Elem.$
=$H.S.
=$Equals Total Equals Total Fee:$=$
Fee WAIVER:
Fees Waived:()Yes6 If yes,reason:No
7ACKNOWLEDGEMENT:
The above respresentatiors as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
not true.Certificate shall automatically terrmr^J^and the appropriate City/Ccunty shall be notified.
Developer/Applicant Signature:
7 are
CERTIFICATION:
This certifies that the above named Developer/Appliccint has paid school facility fees in compliance with Government Code Sections 53080 and
65995.A8
pre^eoiafi^-Anaheim Union High School DistrictDateRi
ACTUAL FEES PAID:3^3$^,39^-
$0.
Check No.
Check No.
9
Anaheim Union H.S.Dist
Distribution:Oeveloper/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department