701 N ROSE ST BAnaheim Union High School District
SDI Crescent Way, P.O. Box 3524, Anaheim, CA 92503-3520
(714)999-5454
CERTIFICATE of COMPLIANCE 2014 -
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 $30.00 administrative fee.
RECEIPT NO.: JELEMENTARY DISTRICT: HIGH SCHOOL DISTRICT:
1 Anaheim Union High School District
UPI I HEI M ��
WNER INFORMATION:
Name: �tukx;(2 tA/ EJGC/ k p
2
Address: 7p / /1! ,CEO SQ P-,��20� �uQ % t G�f9 9 2(100
Phone Number: Home (3f-S 2 y3 - Z Cell ( )
APPLICANT INFORMATION:
3 Name: �' /) rt /
Phone Number: Home ( ) Cell ( )
PROPERTY INFORMATION:
Project Address: ¢C/ ✓L kDSe Ae-ict(
I Development Type: ( ) Residential - New P VP I� ( )Residential -Room Addition ( ) Commercial:
Y ) Single Family ( ) Multi -Family Condos/Apartments # of units:
Project Name:
COMMERCIAL: RESIDENTIAL:
Total Square Footage: Total Square Footage:JN
Multiplied by Current Rate Multiplied by Current Rate Elem.$ �1 =$ Elem.$ 01.5'05=$ alg-3-391
H.S. $ =$ H.S. $9-"295 =$
Equals Total Fee: $ _ $ Equals Total Fee: $ _ $
FEE WAIVER:
Fees Waived:( ) Yes ( '`/) No If yes, reason:
AMONOWLROGE'rGW:
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 Clty/County shall be notified.
Developer/Applicant Signature: ;; —` -&z r
CERTIFICATION:
This certifies that the above named Developer/Appfi chool f1t>"s adli r escompliance with Government Code Sections 53080 and
659 .
II
Date sentative - na nion High School District
ACTUAL FEES PAID:
ArvA�-ir:'i M Fsp s SU3.3�i Check No. DO(o29ofj(D01>
Anaheim Union H.S. Dist. $ �-qa 3. Check No. O D(e 'K)II 1)6
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department