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BLD2020-05123/05124Anaheim 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
'RE t r!i
AUli 1 o 2021
NOTICE: The90-day period in which you may protest the fee described herein will begin on the date this fee is pa,,..._.==� as 1��6sed by the
City or County as a condition of approval for your project, and you have received the requisite notice, the90-day protest period �n at the'ftme your
project was approved. Returned checks (NSF) are subject to a $30.00 administrative fee
RECEIPT NO.: 5 S .2 LD
OWNER INFORMATION:
Name:
Address:
Phone Number:
APPLICANT INFORMATION:
Name:
Phone Number:
PROPERlY INFORMATION:
ELEMENTARY DISTRICT: HIGH SCHOOL DISTRICT: So..�"""'""....,.. �� Anaheim Union High School District
Home (J¼ Y'f }----JI 7 l Z..Cell (
ProjectAddress: t 2.-[°f S, fRJ:r[otJf SJ·,A-r,JFJHEtN / C. ft-. 9'j_c;p 1
DevelopmentType: ( ) Residential -New ( ) Residential-Room Addition ( ) Commercial: -()() Single Family ) Multi-Family Condos/Apartments# of units:
Project Name: A-Du � d
COMMERCIAL: RESIDENTIAL:
Total Square Footage: Total Square Footage:
Multipiled by Current Rate Multipiled by Current Rate
___ =$ _____ _
___ =$ _____ ___ ____ =$ Equals Total Fee:$ ____ = $
Fees Waived: ( ) Yes No If yes, reason:
ACKNOWLEDGEMENT:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995.
A./ t_ )-;;i..o:z-I�IDate
ACTUAL FEES PAID: ==:;;,<A.Y� �c� �.
Anaheim Union H.S. Dist.
$ _ ___,_I .L.:;.3=-;.�-!--. _oo __
$ __ 1__,_,�G;�l&�•-1.J'O __
Check No. ___ /_-,1-'---')�--
Check No. ____ l-=.!3�3.-c__ __ _
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department