139 W SIRIUS AVE0LD7D'22
Garden Grove Unified School District
Certification of Compliance
Payment of School Facility Fees
Developer/Applicant
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Telephone Number
Project Location
Street Address City ZIP(/J^l-hn (jTuck/^
0em.School Int.School High School Thomas Map No.
OFFICE USE
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Number of Square Feet
of Residential Space ^iT7W.z-/X Total $.
Number of Square Feet
of Commercial and
Industrial Space X Total $.
The above representations as to square footage are true.Developer/Applicant agrees that if it is
later determined that such representations are not true then this certificate shall automatically
terminate and the appropriate City/County shall be notified.
Applicant is hereby noticed that any party filing a protest regarding the imposition of fees
pursuant to Government Code Section 65995 and Education Code Section 17620 must do so
within 90 days from the payment of the fee.
Receipt of Payment
This certifies that the above-named Developer/Applicant has paid school facility fees in
compliance with Government Code Section 65995 and Education Code Section 17620.
jc jThese^ee have been received from
inkCheckCheckNo.Cash
Date 'Superintendent DesigneeGardenGroveUnifr4ySchoolDistrict(714)6^3-6442
9703.69*(Rev.6/14)