2130 S. SPINNAKER ST, B1
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Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714)999-5454
BLD2023-02125
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 $30.00 administrative fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
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Af5I
Anaheim Union High School District
OWNER INFORMATION:
Name: p`'HV0MG meft D6
Address: 9G CAMT01V 0E A-N4+f1-IM CA— ol28F0LI
Phone Number: Home("7t9) 4qS C1015- Cell(-((y) 4C1.5 9015
APPLICANT INFORMATION:
Name: ,d (Pfiuwls i\&A- fro
Phone Number: Home('( f") Ljq S Cell ( )
PROPERTY INFORMATION:
Project Address: 2( 3Q S0. cp wNA-Kc[2 Sr /}-hl/rHF[ tv GGf- q 2-go
Development Type: ( ) Residential - New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments N of units:
Project Name:
COMMERCIAL:
RESIDENTIAL:
Total Square Footage:
Total Square Footage:
Multiplied by Current Rate
Multiplied by Current Rate
Elem.$ =$
/1
Elem.$ 2.3 S=$ l y •S1J
H.s. $=$
H.S. $ 2.375"=$ 70.53
Equals Total Fee: $ _ $
/l
Equals Total Fee: $'7
FEE WAIVER:
Fees Waived: ( ) Yes o If yes, reason:
ACKNOWLEDGEMENT:
T e above respresentations as to square footage are true, Developer/Applicant agrees that if it is later determined that such respresentations
a not true, Certificate shall automatically termin d the appropriate City/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.
Date Representative - Anahei h School District
ACTUAL FEES PAID:
2
��D $ /,1 -lo'! 3 Check No. 1331
Anaheim Union H.S. Dist. $ l"I f %0 •23 Check No. r/ 0
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department