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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:
q3,c._d.../1_p AE�l'::::::. Anaheim Union High School District N\
Name: ./44/2.;JE" ciWNEll INfOilMAflON:
. . . , �Address: ,") 3..:i° o� . · ' . � I, ;6';JA � Cf-'j)__;yo j ---...·
Phone Number: Home (�J--f'l_'Y/-O<;, d---'S-r • Cell ( 3'4}.) 7 8'/ "-0 C c:), t-
APPLICANT INFORMATION: ..
Name:
Phone Number:
4JA,e:.µe �
Home (3oJ...) 'J... 8' ( '-! 0 C .)...r
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Cell (3'6d-)
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C/8' { -"( ,;;_.5-
PROP�RlY INFO_RMATION: trh-, l) ;;-f. fr1// -/4,//; Cf Project Address: -:5--3 d--l); 1J-!?os
Development Type: () ResidenF:N!V( · ) Residential -'Room Addition / ( ) Commercial:
( ) Single Family (V)Multi-Family Condos/Apartments# of units:
Project Name: A"'\:>u' �-.
COMMERCIAL: RESIDENTIAL: Total Square Footage: Total Square Footage: )_;2 t_:/__ Multipiled by Current Rate
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Multipiled by Current Rate · � Elem. s = $ Elem.$ :Z �A/ =$ II �¼-'Ito'
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Eq
FEE WAIVER:
Fees Waived: ( ) Yes
ACkNDWLEBGEMENT:
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$ =$
(j}No
=$ H.S. $ :2,tJ � =$ I, 'Y'2l'Q•9to 7 Equals Total Fee: $ =$
If yes, reason:
The above respresentations as to square footage are true, Developer/ Applicant agrees that if it is later determined that such respresentations
. . 0 are not true, Certificate shall automaticall� and the appropriate City/County shall be notified .
Developer/Applicant Signature:1'1A o /)�/ I
CERTIFICATION: \./
This certifies that the above named Developer/ Applicant has paid school facility fees in compliance with Government Code Section s S3080 and
65995.
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Date
ACTUAL FEES PAID: A e:-!=:::,, � $ Anaheim Union H.S. Dist. $
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Re�ta�e -Anaheim Union High School District
// -y' /(o. 9lo
I, • -::t_�& 9Lo Check No.381 g-
Check No., -::2:> g, I '>
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department
BLD2020-01864