705 S MACDUFF ST, BAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454 RECEIVED
UNLIMITED
●
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES BUILDING DiVl!;!D;:
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRia:
Anaheim Union High School District1
OWNER INFORMATION;2
: Address:
Name:
Phone Number:Home (
PPUCANT INFORMATION:
Name:j^crc^'ZCell3?/3Q 39 ^Phone Number:Home (
PROPERTY INFORMATION:
k.uyn2^Project Address:
Development Type:('^^Rejjd
{/■''jingle Family
SImar4 ()Commercial:ential -New ()Residential -Room Addition
()Multi-Family Condos/Apartments #of units:
Project Name:
5»COMMERCIAL:
Total Square Footage:
Muitipiled by Current Rate
Elenm^
RESIDENTIAL:g3>Total Square Footage:
Muitipiled by Current Rate /;7V 5 =S Elem.S
=s H.S.
●ee:$Equals Jj =$=$Equals Total Fee:$
FEE WAIVER:
6 Fees Waived:{)Yes If yes,reason:No
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,Developer/Appiicant agrees that if it is later determined that such respresentations
are not true,Certificate shall automatically
Developer/Applicant Signature:_
7 inate and the appropriate City/County shall be notified./texBji A-p-dryft'rO
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8
3r
iNtepr^^entative -Anaheim Union High School DistrictDate
ACTUAL FEES PAID:\
/nQ /O^Z>
Check No.
Check No.
n.9
Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department