1640 S CLAUDINA WAY (3)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
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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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER INFORMATION:,
Name:/VM/HfeliU "=9lLA/A
Address;
Phone Number:Home(}Cell('^1L|)
2
APPLICANT INFORMATION:
Name:
Phone Number:Home ()
3
Celli^^t)<^Q>\
PROPERTY INFORMATION:
Project Address:|
Development Type:{)Residential -New ()Residential -Room Addition (Vj Commercial:
{)Single Family ()Multi-Family Condos/Apartments #of units:
4
Project Name:
|RESIDENTIAL:COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate
5 Elem.$_
H.S.$
=sElem.
=$
●ee:$Equals Total Fee:$=$qualsTpiai
FEE WAIVER:
Fees Waived:{)Yes
I
6 If yes,reason:No
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
are not true.Certificate shall automaticallytarminate and
Developer/Applicant Signature://—
7 ite City/County shall be notified.appn
CERTIFICATION:
This certifies that the above named Developer/ApplicaQt-hffTpaiT school faciliiy-^
65995.
I ^0
es in compliance with Government Code Sections 53080 and
2.-\-'X’8
Date -Te^^tative -Anaheim Union hodi District
ACTUAL FEES PAID:
Lq.$Check No.
Check No.
9
$An^jjdimrOnion H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department
Ihdoc/developerfee/coc