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501 N VINE ST (2)Anaheim Union High School District 501 Crescent Way, P.O. Box 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 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: Z_��70 I--- S Anaheim Union High School District Name: Address: py 5 t Phone Number: Home (-71'() Cell ( ) INFORMATION: Name: l.iuh4c eqI Phone Number: Home (dry ) 5 S S' - 9i &C, Cell ( Project Address: ;z \ ,1,. , k S k �- weAWo Development Type: ( ) Residential -New ( ) Residential - Room Addition ( ) Commercial: ( x) Single Family ( ) Multi -Family Condos/Apartments # of units: Project Name: C n _ o Total Square Footage: Total Square Footage: led by Current Rate Multipiled by Current Rate Elem. .S. $ $ H.S. $_-;23S=$ .vrai ree: = $ Equals Total Fee: $ = $ WAIVER: Waived: ( ) Yes (� ,,j No If yes, reason: above respresentations as to square footage are true, Developer/Applicant agrees that if it is later determined that such respresentations not true, Certificate shall automatically terminate and the appropriate City/County shall be notified. Signature: certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 15. Uate Representative-e)knaheim Union High School District ACTUAL FEES PAID: A F_ S't� $ Check No. / 33 Anaheim Union H.S. Dist. $ J, 3 Los. / Check No. you �uuum r. ueveloper/AppllcanT, AUMIJ Accounting Department, Elementary School District Accounting Department CI-Y OF ANAHEIM PLANNING DEPARTMENT BUILDING DIVISION SCHOOL FEE FORM Customer Information: Name of Applicant/Owner: Carlos Perez Contact Phone Number: 71 4-595-2591 Project Information: Project Address: 501 N. Vine St #B Plan Check Number: BLD2020-04848 Development Type: Residential Single Family Square Feet of Living Space = 57 (Additional Deuced Garzge Conveslan 8 AddiLon !o ADU 570 ) Residential Single Family Square Feet of Living Space = (Additional Notes: ) Commercial Square Feet = (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 • for AUHSDemad: hauck_1@auhsd.us *Orange Unified School District: 1401 N. Handy Street; Bldg. F, Orange, 92867 -(714) 628-5371 *Placentia School District: 1301 E. Orangethorpe Avenue, Placentia, 92870 - (714) 986-7000 *Garden Grove Unified School District: 11700 Knott Avenue; Bldg. C, Garden Grove 92841- (714) 663-6442 *Return payment receipt or waiver to the City of Anaheim Building Division* Date: 2/27/23 City Employee: W. Menendez