418 W HAMPSHIRE AVE Brmndmmirt union mign bc1001 ulstrict
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
Zozu- 02.
CERTIFICATE Of COMPLIANCE �LD ()3-7
PAYMENT of SCHOOL FACILITY FEES
NOTICE: The 90-d2y 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 $30.0o administrative fee.
RECEIPT NO.: ELEMENTARY DISTRICT: HIGH SCHOOL DISTRICT:
1 Anaheim Elementary KA
L school District (AESD) Anaheim Union High School District (AUSSD)
OWNER INFORMATION:
Name:
2 Address:
Phone Number: #ome5�) Cell ( )
3 I Name:
Phone Number: Home
I Project Address:
4 Development Type:
Project Name:
Cell ( )
418 W. HAMPSHIRE AVE., Or ANAHEIM, CA
( g) Residential -New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments k of units:
24-02037 DET ADU
Total Square Footage: Total Square Footage: 680
Multiplied by Current Rate Multiplied by Current Rate
5 Elem.$ _$ Elem.$ 2.585=$ 1,757.80
$ _$ H.S. $ 2.395 =$ 1,628.60
Equals Tot
Equals Total Fee: $ _ $
FEE WAIVER:
6 Fees Waived:( ) Yes (x ) No If yes, reason:
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true, Develop plicant gr s that if it is later de med that ch respresentations
7 are not true, Certificate shall automatically 'nate and the approp ' e City ou shall be notifie .
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compli nce with Government Code Sections 53080 and
65995.
i ---
Date Representative',- Anaheim Union High School District
ACTUAL FEES PAID:
i.Anaheim Elementary -� 1,757.80 9 School District (AESD) Check No.
2.Anaheim Union S.S. Dist. (AURSDI Check No.�q
,
Distribution: Developer/Applicant, AUH5D Accounting Department, Elementary School District Accounting Department