1030 N PAULINE ST (3)received
MAY 2 6 2022
Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
CITY OF ANAHEIM
PLANNING &BUILDING DEPARTMENT
ANM«f kMCN 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 $30.00 administrative fee.
HIGH SCHOOL DISTRICT:
Anaheim Union High School District
ELEMENTARY DISTRICT:RECEIPT NO.:
Ar\1
OWNER INFORMATION:
Name:Anthony Hernandez
Address:174 E liberty anaheim ca 92801
Phone Number:Home (714)698-0930
2
966-3656Cell(949)
APPLICANT INFORMATION:
Name:Will Hernandez3
)949-966-3656Cell{Phone Number:Home {
PROPERTY INFORMATION:
Project Address:1030 N Pauline St Anaheim 92801
Development Type:()Residential -New ()Residential -Room Addition (x)Commercial:
()Single Family ()Multi-Family Condos/Apartments #of units:
4
Project Name:
RESIDENTIAL:COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate
70
Elem.$
H.s.=$Lo
Elem.S5
=SEqualsTotalFee:$
FEE WAIVER:
Fees Waived:()Yes v16 If yes,reason:No
ACKNOWLEDGEMENT:
iperyAopficant agrees that if it is later determined that such respresentations
The appropriate City/County shall be notified.
The above respresentations as to square footage are true,^
are not true,Certificate shall automatically terminatf7
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995 \t8
helm Union High School DistrictDate
ACTUAL FEES PAID:
9
Anaheim Union H.S.Dist.
I O o^woCheckNo.
Check No.
$
$
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department
2021-2022