802 S CLEMENTINE ST B8
9
Anaheim Union Nish School District
501 Crescent Way. P D lio• 3520, Anaheim, CA 91 ell 3520
(714) 999 5454 13LD 20 z
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
NOIIC( i11a904ryperod n Mlerh you ems protest the lee dritnted hews wee w on the drlelha IK a rt Me t
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bgan al the lane l'otw P'orerl fn lopa.td Mtrntdattrtar(NYi a'e sub)•tt lea $30.0d adn NKbaalM/aa
RECEIPT IYD.: f�EM PTF Y iSTRIR HIGH SCHOOL DISTRICT KA
LO �9 School Dutrcl 1ery fAES Anaheim Union nigh School Drstntt(AUHSD)
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Phone NtenberHont ( ) Cell 1� ly 1 1-4j A 4 VIA
AP1l1CANT sY:oIIMATION: Y��
Name PA4
Phone hl Abe• Ibmei I_ __ Cell ('114) Laa-41a71___.
ProRta"ll 802 S. CLEMENTINE ST. UNIT R ANAHEIM, CA
De Hopmerr Type IXI Revdenbal -New 1 IReudentutl - Room AdGtla. 1
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w t>lect wme:
1 E -02024 Z i692 GC ADU 1 "u"'Famly Coroos/AparotKnu X of untie
COM M ER CIA): RESIDENTIAL:
7o tal i 197
Sgmm Ftaixaee: Iota Scui<e Footage. -
MWts 1:11:orreni Mtt '' Mu1lPkdbyl[ur Ml Rate
S [tnas _ • S Ekm 52.585 e%094-25 _
5 •$ „s $ 25s313�Jd33
Eau+h Tot ,S •$ EI Total Fee. S,_=S
1 Wmed. l ) Yes ( X} No Iye; resson.
above lespers tatrdro as to a= lGotaee a rue, Dt1*D1oN/APQ1KA`)t Greet Thal /It Is late, detttme�ed that such resvltsenutwns
hql 11w, Grit/K:alt shall Auto mA tl<ally trrml a %ndyaflp�bpnate Cltyrt'c 4ray that be not feed
,elopet/AppliCant Signature:
eenOws that theatroue nal Desebprr/A.PPkant hat o" W%w lacillItYleesN eOM1004 MwenGUsernrnMt Code S--tlonI 53090and
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Union High School Dlsttltt
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