232 W SIRIUS AVE BNo. 7036
Developer/Applicant
Address
Telephone Number
Garden Grove Unified School District
Certification of Compliance
Payment of School Facility Fees
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Project Location
Street Address City ZIP
OFFICE USE
Elem. School Int. School High School Thomas Map No.
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Number of Square Feet ✓ /_..
of Residential Space 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
pursuant to Government Code Section 65995 and
within 90 days from the payment of the fee.
Date
a protest regarding the imposition of fees
Education Code Section 17620 must do so
Developer/Applicant
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.
These fee have been received
Cash Check Check No. Bank
Date /
Dollars $
Superintendent Designee
Garden Grove Unified School District
(714) 663-6442
9703.69` (Rev. 6114)