551 S CONCORD PL BAnaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714) 999-5454
[3L172.OZU- Cam) -)
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 $30.00 administrative fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT: KA
// --
Anaheim Elementary
Anaheim Union High School District (AUIRSD)
C�
School District (AESD)
OWNER INFORMATION:
Name: Khang Dinh
Address: 551 S Concord PI
Phone Number: Home (714 )393 2808 Cell ( )
APPLICANT INFORMATION:
Name: Hao Hong
Phone Number: Home (949) 532 4632 Cell ( )
PROPERTY INFORMATION:
Project Address: 551 S. CONCORD PLACE #B, ANAHEIM, CA
Development Type: ( X) Residential - New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments # of units:
Project Name: 24-00540 CG ADU
COMMERCIAL:
RESIDENTIAL:
469
Total Square Footage:
Total Square Footage:
Multipiled by Current Rate
Multiplied by Current Rate
Elem.$ =5
Elem.$ 2.395 =$ 1,123.26
$ _$
H.S. $2.395 =$ 1,123.26
Equals Tota : $ _ $
Equals Total Fee: $ _ $
FEE WAIVER:
Fees Waived: ( ) Yes (X)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 the appropriate City/County shall be noted.
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 res ntative - Anaheim Union High School District
ACTUAL FEES PAID:
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1.Anaheim Elementary 1,123.26 Check No. %5�9// 3
School District (AE 1,123.26 Check No. y 7-� 33
2.Anaheim H.S. Dist.
Union (A[IHHD)
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department
CITYUf HlvFltlru11 r
I
BUILDING DIVISION SCHOOL FEE FORM
(714)765-5153IBuildingDivision@anaheim.net
Name of Applicant/Owner: KHANG DINH
Contact Phone Number: (714)393-2808 _
r..c.,.�. n+i^n-PacziriPntial Addition: 469 sq. ft to convert detached gar'__ to ADU
Project Address: 551 S CONCORD PL B
Plan Check Number: BLD2024-00540
Development Type:
Residential Single Family
Additional Not
CONVERTED DETACHED GARAGE
469
$q .Ft. of living Space = (
Residential Multi Family
tt of Units = - _
Sq. Ft. of Living Space = (Additional Notes): _
Commercial
Sq. Ft. _ (Additional Notes):
- --.
School District Information
Please contact the following School District office:
Anaheim Union High School District 501 N. Crescent Way, Anaheim, CA 92801 - (714) 999 5454
'loi AUNSI)em4A hewAJv'.' �
'Orange Unified School District: 1401 N Handy Street; Bldg. F, Orange. 92867 -(714) 628-S371 "
4 Placentia School District: 1301E orangethorpe Avenue, Placentia, 92870 - (714) 986.7000
`Garden Grove Unified School District: 11700 Knott Avenue; Bldg C, Garden Grove 92841 - (714) 663-FA42
'Return payment receipt or waiver to the City of Anaheim Building Division"'
Date: 6.12.24 City Employee: TDEDMAN
282111107 612023 8810004306
D COCUMENTATANGLE TO VIEW AN r IYIU: isAIc m MVN 01VRaIRiCR a'= � �{� �q f•1���q,�: ;or i
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Remitter. KHANG XUAN DINH
Pay To The AUHSD
Order Of:
Pay: ONE THOUSAND ONE HUNDRED TWENTY THREE DOLLARS AND 26 CENTS $'-1,123.26 "
Gnwer. JPMORGAN CHASE BANK, N.A.
Do hotwrtle eutsi oth¢box
Memo: -------- ----=— Rebecca Griffin, Chief Administrative Officer
Note: For information only. Comment has no effect on bank's payment. JPMorgan Chase Bank, N.A.
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CHASE ,,p
Remitter. KHANG XUAN DINH
Pay To The AESD
Order Of:
282111107 6/2023 8810004306
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07/25/2024 vol
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Pay: ONE THOUSAND ONE HUNDRED TWENTY THREE DOLLARS AND 26 CENTS $" 1,123.26 "
Drawer. JPMORGAN CHASE BANK, N.A.
Do not write outside this box ,
__— ________ —
Memo:_________________�______________________�____ .. - Rebecca Griffin, Chief Administrative Officer
Note: For information only. Comment has noeffect on bank's payment. JPMorgan Chase Bank, N.A.
Phoebmx,AZ—_____..
n09S94722334u• 1:122L000241: B06002234u'