2157 W LA PALMA AVEAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITEDYOU
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CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES Vh JPlbTD'O
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 $30.00 administrative fee.
HIGH SCHOOL DISTRICT:
Anaheim Union High School District
ELEMENTARY DISTRICT:RECEIPTNO.:
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OWNER INFORMATION:.rVc\Aa\-
''Rr^r.ri
LLC-
.V73'/ft hi nr
Name:
Address:C)rn\^rA^.Ca2
7 /
Cell (Phone Number:Home (
APPLICANT INFORMATION:Y.fn.ri n.rri l>/c-lopnnr.nf,l.gc.Phone Number:Home({p^7^.^3.0-^33^
Name:3
Cell(
PROPERTY INFORMATION:
Project Address:,3 1 .‘O “7 V\/.\fx
Development Type:()Residential -New {
()Single Family
'OrArr^r.T'/mi 1^)Residential -Room Addition ^{v^}Commercial: 4
{)IVIulti-Familv Condos/Apartments ff of units:
Project Name:
RESIDENTIAL:COMMERCIAL:
Total Square Footage:
Multipiled by Current Rate
3.g^G?6 Total Square Footage:
Multipiled by Current Ratei
●37 Elem.$Elem.$5
H.S.H.S.
=$Equals Total Fee:$=SEqualsTotalFee:$
FEE WAIVER:
Fees Waived:()Yes6 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 automatically
Developer/Applicant Signatufe^^
7 ropriate City/County shall be notified.«■
/
CERTIFICATION:
This certifies that the above named Deveioper/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8 ■V
Anaheim Union High School DistrictRepreser<ativDate
ACTU^FEES PAID:,Lo I
Check No.
Check No.
$9 C>/$£2AnaheimUnionH.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department
2021-2022