712 S. YANA DR, UNIT BUnion High School District501CrescentWay,P.O.Box 3520,Anaheim,CA 92803-3520 RECEIVED
(714)999-5454
UNLIMITED
MAR 0 6 2023
CITY OF ANAHEIMPLANNING&BUILDING DEPARTMENTCERTIFICATEofCOMPLIANCE
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DlSTRia:
Anaheim Union High School District Af\1
INFORMATidN:
Name:
Address:2 ●^rG»\jo-
Phone Number:Home(~7iv^)Cell(
APPUCANT INFORfVIATlON;
Name:
Phone Number:Home(li^)-
3
Cell(
PROPERTY INFORMATION;
Project Address:
Development Type:{)Residential -New ()Residential-Room Addition
(X.)Single Family
dA 9XS-OS-4 ()Commercial:
(}Multi-Family Condos/Apartments #of units:
&Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
H.S.5^39^=S
5 ElemA^=$Elem.
=$
EqualsJotSTFee;$=S Equals Total Fee:$=$
FEE WAIVER:
Fees Waived:{)Yes6 No If yes,reason:
ACfCNdWLEDGEMENT:
The above respresentations as to square footage are true,Deveioper/Applicant agrees that if it is later determined that such respresentations
are not true.Certificate shall automatically terminate and the appropriate City/County shall be notified.7
Developer/Applicant Signature:2
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8 I Lo\X^Representativ£^naheim Union High School DistrictDate
ACTUAL FEES PAID:
Anaheim Union H.S.Dist.
$Check No.
Check No.
9
$
Distribution:Deveioper/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department