1760 W ORANGE AVE, BAnaheim Union High School District -
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
6C.D 2022-0^11^^\
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 $30.00 administrative fee.
RECEIPT NO.:^EMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheinri Uniori High School District(pDOO1
OWliERfNFdiRMAtiON:
Name:
2 Address:f '7 Cfi O ^
Phone Number:Home () Cell (*7/V)/^CfO
●-T7*'1
S /r?A ‘O S pt-tU ip’jName:3
Cfiiin/Yi 7^r-/yoQPhoneNumber:Home {
PROP^TY INFORMATION:
Project Address:in(pQ <V OTt^n
Development Type:{)Residential -New {><)l
Family
Resid4 ()Commercial:
()Multi-Family Condos/Apartments #of units:
sidentia!-Room Addition
^3ProjectName:/
COMMERCIAL:RESIDENTIAL:
nSaL^uare Footage:
Multiplied by CurrehS^^e
Elern^$«i
H.S.$
Total Square Footage:
Multiplied by Current Rate
^Elem.S \n^=S )>33^.
^H.S.sq.3?5 =si3il .2,1
5 =$
=$
Equals Total Fee:$=$Equals Total Fee:$=S
FEE WAIVER:
6 Fees Waived:(}Yes )No If yes,reason:
The above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentationsarenottrue.Certificate shall automatically terg((in^^and the appj:^iate City/County shall be notified.
Developer/Applicant Signature:
7
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8
Date Representative -AnahertnUnion High School District
ACTUAL FEES PAID:
Anaheim'Union H.S.Dist.Check No.Q2M0^l
Check No.9
Distribution:Oeveloper/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department