216 N BROOKHURST ST BAnaheim Union High School District
501 Crescent Way, P.0 Boa 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 hegin 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 $30,00 administrative its.
RECEIPT NO.: ELEMENTARY DISTRICT: HIGH SCHOOL DISTRICT: SA
1 �Z Anaheim Elementary gnaheim Union High School District (At1H8D)
School District (ARSI
OWNER INFORMATION:
Name: Samy Beshay Golden Way Investments LLC
2 Address:
Cell (714) 3354400
Phone Number Home (714 )asc "i50c _
3 Name: Samy Beshay Golden Way Investments LLC
Phone Number: Home 714 )
6555509 Cell (714 ) 335 4400
PROPERTY INFORMATION:
Project Address: 216 N. BROOKHURST ST. , *B, ANAHEIM, CA
4 Commercial:
Development Type: I X)Residential -New ( I Residential -Room Addition ( )
( ) Single Family ( I Multi -Family Condos/Apartments d of unit_
Project Name: BLD2024-03260 ATT GC ADU
COMMERCIAL: RESIDENTIAL: 993
Total Square Footage: Total Square Footage:
Multipiled by Current Rate Multiplied by Current Rate
EIem.S 2.585 =5 2,566.91
5 Elem.$ =$ H.S. S 2.585 _$2,566.91
5 =5
Equals Tota : 5 = S Equals Total Fee: 5 = 5
FEE WAIVER:
6 Fees Waived: ( ) Yes (X) No If yes, reason:
(ACKNOWLEDGEMENT:
The above respresentations as to square footage are true, Developer/Applicant agrees thattf R Is later determined that such respresentations
7 are not true, Cerhficate shall automatically terminate and the appropriate City/County shall be notlRed.
8
Signature:
i irrc,,sr
certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections S3080 an
Date
Representative - Ana�6'im Ugon High School District
ACTUAL FEES PAID:
1. Anaheim Elementary ---> $ 2,566.91 Check No.
9 school District fAESD) $ 2,566.91 Check No.
2.Anaheim Onion tt. S. Dist.
Distribution'. Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department
sres-am: