1221 S AUTO CENTER DR (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
n
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 periodbeganatthetimeyourprojectwasapproved.Returned checks (NSF)are subject to a $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1 KA^g 3 r>
OWNER INFORMATION:
Name:
Address:\Cl\S
Phone Number:Home ~
vv\
Cell(
APPLICANT INFORMATION:
Name;
Phone Number:HomeHm)-*^^22-
*3
Cell(
PROPERTY INFORMATION:
Project Address:
/*Development Type:()Residential -New ()Residential -Room Addition
()Single Family j\^)Commercial:()Multi-Family Condos/Apartments#of units:
Project Name:
COMMERCIAL:RESIDENTIAL:
Total Square Footage:^^
Multiplied by Current Rate _
Total Square Footage;
Multiplied by Current Rate
Elem.$.5 r$=S
H.S.H.S.$=$
Equals Total Fee:$EquaJs.Td?ai Fee:$=$_
FEE WAIVER:
Fees Waived:{)Yes6 No If yes,reason:
ACKNOWLEOGEMENT:f"A
The above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
are not true,Certificate shall automatically terminate and the appropriate City/County shall be notified.Developer/Applicant Signature;^0
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8
)fepi;es^ative -AnaheimUmon High School DistrictDate
ACTUAL FEES PAID:
’g~3S’.3CoA$Check No.
Check No.
9 s ^3.:^.:^LaAnaheimUnionH.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department