412 E SYCAMORE ST, BI
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Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714)999-5454 F)U. `'X5,20`0330_
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 I
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 period
began at the time your project was approved. Returned chedw (NSF) are subject to a $30.00 administrative fee.
RECEIPT NO.: ELEMENTARY DISTRICT: HIGH SCHOOL DISTRICT:
1PQ-7' 'A Anaheim Union High School District
IbWNER INFORMATION:
Name: iVIQY1
Address:
Phone Number: Home(J(f.()
Cell (
111F RR rwnvI..
Name:t4 (AT I G 04010tL
Phone Number: Home (I III 3 aR .yg 3 3 Cell ( )
�f111>u'
Project Address: Li 1 Z G Sy ( G Mo r e i1-yicih el M c R Q2US
Development Type: ( ) Residential -New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments # of units:
Project Name:
�/CnYtML. nLi�VL� II'9L. y
Total Square Footage: Total Square Footage: 55 -/
led by Current Rate Multipiled by Current Rate
_ $ Elem. $ Z 3T 9 =
H.S.HS. $ =S /7HQS. SL•✓�1r `� =S f32 OL
Total Fee: $ _ $ Equals Total Fee: $ `T• ! -/ _ $ Z— �O • 163
IFEE WAIVER:
IFees Waived: ( ) Yes (V� No If yes, reason:
['F IACKNnWI FnF �,�
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 and the appropriate City/County shall be notified.
Signature:
certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
High School District
ACTUAL FEES PAID:
$ 3 Check No. QQU
Anaheim Union H.S. Dist. $ . U7— Check No. 6/14an�
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department