202 S CORNER ST, Be
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Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714) 999-5454
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
NOTICE: The 9D-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 period
began at the time your project was approved. Returned chedcs (NSF) are subject to a $30.00 administrative fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
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Anaheim Union High School District f Y \
OWNER INFORMATION:
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Name: SGA-t&L
Address: Zd Z 5 60 "Sm <� %.
Phone Number: Home (&t) Szg 7b Z—j Cel((8 2) 8Z9 '762._7
A PLICANT INFORMATION-:
Name:�n!
Phone Number: Home(66Z•) 62j`7 762� Cell(6ol) 9Z.-t 7L21
PROPERTY INFORMATION:
ProjectAddress: CM —
Development Type: ( ) Residential -New (>C4 Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments If of units:
Project Name: crL CVA"JiSAL ADD ti
COMMERCIAL:
RESIDENTIAL: LQ
Total Square Footage:
Total Square Footage:
Muhipiled by Current Rate
e.$
Muhipiled by Current Rate
Elem.$----/�`/�—_$
=$
H.S. $ =$
H.S. $d��7✓�'--$ y.
Equals T iiiFeeFeeee: $ = $
Equals Total Fee: $ _ $
FEE WAIVER:
Fees Waived: ( ) Yes ) No If yes, reason:
he above respresentations as to square footage are true, Developer/Ap 'ca t agrees that if it is later determined that such mspresentations
re not true, Certificate shall automatically terminate and the appropri e C /County shall be notified.
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
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Date Rep�entative - Anaheim Union High School District
ACTUAL FEES PAID: S<
461? 1?9. ?
7 0 b15
$ / Check No.
Anaheim Um n H.S. Dist. $ j',5•, 2 41 y - 3 Z Check No. fob
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department