915 N. Maple St.
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TOTAL: $ d:19C-l b:-:{ ()
Distribution: White - Acctg
Yellow - Customer
Pink - Reconcile Copy
Goldenrod - Originating Dept.
....Please Do Not Write Below This Line....
Area Used for Cashier Validation
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.llawl 8/li8/05 54 Receipt nOl 92381.
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PUBLIC WORKS DEPARTMENT FEES
-- TRAFFIC ENGINEERING FEES--
BUILD # Z-C>o S - ~()7 2.~
PROJECT SITE: 9/!so N. ).1~1e sf
SIZE: ..s r I
~RAFFIC SIGNAL FEES:
279-412-F724-3017
TE # I~O
pTRANSPORTATlON IMPACT AND IMPROVEMENT F
278-412-F724-1818
o TRAFFIC SANTA ANA CANYON FEE:
278-412-F724-2001
o EASTERN TRANSPORTATION CORRIDOR FEE:
101-412-F724-6704
COMMENT:
REVIEWED BY: ALFRED YALDA (714) 765-5183 A \.f
DATE:~-2.~-oS
--DEVELOPMENT SERVICES FEES--
-,~ 1 ~.
RIGHT OF WAY . v-o REVIEWED BY DATE:
o OLD ZONING CODE (i.e. in plan check or entitle ent prior to July 8, 2004)
~NEW ZONING CODE
LV- 7IJ-CfS,
DEDICATION
CREDIT
~
.-;'
STREET IMPROVEMENTIREP AIR
/,..
SEWER CONNECTION FEE ..j ~. ~t) ACCT #
CITY SEWER ASSESSMENT .;.I/A- ACCT #
DRAINAGE ASSESSMENT FEE /I. ~ ACCT #
GRADING: 1<1!i:J?.'~//:!E1)
WATER QUALITY MANAGEMENT PLAN (wQMP) Yf1
LAND SUBDIVISION: Kt ij UA-t::1tPoo5t5...3
REVIEWED BY: ~N -Ih/6. ~5
~
Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714) 999-2188
(714) 520-5741 FAX
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 gO-day protest period began at the time your project was approved.
ReCd{<~ t
Elementary District:
SoD
High School District'
Anaheim Union High School District
Owner Information:
Name:
Address:
Phone Number:
/ w-.-
)
Applicant Information:
Name:
Phone Number: (
'->~ C:?xL O~,
Property Information,
Address of Project:
Development Type: [I,) Residential - New
Project Name:
\5a----ree-. a-'<t ~.
[ ) ReSidential - Room Addition
] Commercial
Type:
[ ) Single Family
[
Multi-Family Condos/Apartments - # of units:
Commercial:
Total Square Footage:
Multiplied by Current Rate: Elem. $
H.5. $
Equals Total Fee: $
-$
-$
-$
Residential:
[ ) Level 1 [ ) Level 2 - ACSO Only [ J~S" - ACSO Only
Total Square Footage: .::, ~.;
MUlt,phed by Current Rate: Elem. $ ~= $ /73;( . t
H.S. $ / / V = $ J 7?Z.~'
Equals Total Fee: $ c:?;;L f i:i' st~.s.-: . .
Fee Waiver:
Fees Waived:
Yes
. No
If yes, reason:
Acknowledgement:
The above representations as to square footage are true. Developer/Applicant agrees that if it is later determined that such
representations are not true, Certificat shall automatically terminate and the appropriate City/County shall be notified.
Developer/Applicant Signatur
Certification:
This certifies that the above name'" 0 eloper/Applicant has paid school facility fees in compliance with Government Code
nd 65995.
L/3<J.l t~~W
Representative - Anaheim ~jon High School District
Date
Actual Fee~ ~'?)
t}eJ3 I _
Anaheim Union H.S. District
$
$
I 7-?~. &, <I
IT?::J".C,y
Check No.
Check No.
(O;}...j'
/1')A,6
Distribution: City/County - Developer - Accounting - Elementary District