1667 W CRIS AVE, BAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
fiX)ZD22'cXfiXi
RECEIVED
JUL 0 5 2022
UNLIMITED
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES CITY OF ANAHEIM
PLANNING &BUILDING DEPARTMENT
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER INFORMATION:
Name:
Address:
774-i P4kli')C.2
1
UA7 W
Phone Number:Home(Cell(
APj^LICANT INFORMATION:
Name:
Phone Number:Home(
3 lAi HUlCC
Cell ()1-ZL
PROPERTY INFORMATION:
Project Address:(^67 Lj.-'^ft .
Development Type:()Residential -New {)Residential -^oom Addition4 ()Commercial:
()Multi-Family Condos/Apartments#of units:()Single Family
Project Name:
IKtial
Total Square Footage:
Multiplied by Current Rate
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
5 Elei =$Elem
H.S.$=$H.S.
EqualsJetSlFee:$=$Equals Total Fee:$=S _
FEE WAIVER:
6 Fees Waived:()Yes No If yes,reason:
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 terminate and the appropriate City/County shall be notified.
Developer/Applicant Signature:
7
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8
>3^
RepresenYstjve^^aheim Union High School DistrictDate
ACTUAL FEES PAID:
$Check No.
Check No.
9
$_Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSO Accounting Department,Elementary School District Accounting Department