1629 W LINCOLN AVE (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
8>U>Z(g>2i-
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 wasjimposedbytheCityorCountyasaconditionofapprovalforyourproject,and you have received the requisite notice,the 90-day protest period^gan at the time your project was approved.Returned checks (NSF)are subject to a $30.00 administrative fee.
ELEMENTARY DISTRICT:RECEIPT NO.:HIGH SCHOOL DISTRICT:
Anaheim Union High School District
OWNER INFORMATION:
Name:
Address:
Phone Number:Homef^^^
LlKitli'
2 1000 P'te_yo)hh.s/g,sps-
ceii^^)-f7/y
APPLICANT INFORMATION:Name:EtAtk.
Phone Number:Homef?^t^^0 7—
3
PROPERTY INFORMATION:
is-2^Project Address:
Development Type:{4 Residential -New {)Residential-Room Addition
()Single Family
()Commercial:
(\XMulti-Family Condos/Apartments #of units:cj.Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:7YWTotalSquareFootage:
Multiplied by Current Rate =s lS',2b7M5Elem.$_
H.S.$
=$Elem.
H.S.$=$
Equals Total Fee:$^Equals Total Fee;$=$=s
IFEE WAIVER:
^[Fees Waived:()Yes .j:?)No If yes,reason:
lACKNpWLEOGEMENT:
iThe above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentationslarenottrue,Certificate shall automatically ternjin^te and the a§prop;aJ4e CjtQCounty shall be notified.
lOeveloper/AppIicant Signature:?La-
CERTIFICATION;
This certifies that the above named Developer/Appiicant has pajd school afcHitv fees in compliance with Government Code Sections 53080 and
6599S 3{[\7dZ^8
Date Uniqr High School DistrictRepresentative-Ai
ACTUAL FEES PAID:mb-lS,2M73(/>$Check No.
Check No.
9
Anaheim Union H.S.Dist.r
Distribution:Developer/Appiicant,AUHSD Accounting Department,Elementary School District Accounting Department