1860 W TAMARA LN, BAnaheim Union High School District BL,02 2_'2 0k_19J
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714)999-5454
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
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 checks (NSF) are subject to a $30.00 administrative fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
1013D
Anaheim Union High School District
OWNER INFORMATION:
Name: All) P 4L
Address:1���c/ 1?+1L4A je,+ LN d AHF_ M4 r A q Z'1U
Phone Number: Home ( ) Cell (%/V) 3 B '4—
APPLICANT INFORMATION:
Name:
Phone Number: Home ( ) Cell (7/CIJ �8 3 — 75 CAS
PROPERTY INFORMATION:
Project Address: _ f
Development Type: ( ) Residential - New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments # of units:
Project Name: ��L♦ ��
ESIDENTIAL:
C>.=$
otage: Total Square Footage: �e�da
�� r
Me Multipiled by Current Rate
Elem.,$,�$ e2.d ��C'
lem. $ _ $
$ _$ H.S.
Equals Total Fee:$ 4,195 =$ �002
Eq=$
FEE WAIVER:
Fees Waived: ( ) Yes ( V' 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 a appropriate City/County shall be notified.
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Appl' pal schoo ad I 'n compliance with Government Code Sections 53080 and
65995.
Date Rep ese ive -Anaheim Union High School District
ACT4AL FEES PAID:
$ Check No. ✓ _+'
Anaheim Union H.S. Dist. $ a8 co Check No. 55175
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department
Ihdoc/developerfee/mc