839 S BELLEVUE PL, BAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
O'CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
began at the time your project was approved.Returned checks (NSF)are subject to a $30.00 administrative ee.
HIGH SCHOOL DISTRICT:
Anaheim Union High School District
ELEMENTARY DISTRICT:Receipt NO.;A^s>c>1
OWNER INFORMATION:
Name:
Address:15
Phone Number:Home(
z
2
Cell
Si(L V J
IaPPLICANT INFORMATION;
'Name:3
Phone Number:Home (
PROPERTY INFORMATION:
Project Address:_
Development Type;(
83^5 h’ll^vu^?L B>rA Q2Sb5
)Residentla^^^g^y^OO Residential -Roofr Addition {)'Commerciah()Single Family ()Multi-Family Condos/Apartments #of units:
4
Project Name:
SIDENTIAL:MM[COMMERCIAL;
Total Square Footage:Total Square Footage:
Multiplied by Current RateMultipliedbyCurrentRateElem.S=$Elem.$5
H.S.=$r $
=$Equals Total Fee:$Equals Total£ee?
TFEE WAIVER:
®iFees Waived:()Yes No If yes,reason;
ACKNOWLEDGEMENT;
[ihe above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
not true.Certificate shall automatically terminate an I th^ppropriate City/County shall be notified.
'Developer/Applicant Signature:tP^V
1
[are
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid schopi facili^fees in compliarKe with Government Code Sections 53080 and
659955 /IvW
ntaliye -Anaheim Union High School DistrictRepiDate
ACTUAL FEES PAID:
Check No.
Check No.
$
Anaheim Union H.S.Dist.7
Distnlsution:DcveloDer/Appllcant,AUHSD Accounting Department,_0^mentarY School District Accounting Departmertt