1206 E OAK ST (2)naheimUnion High School District
UNLIMtTED 501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
RECEIVED
FEB 1 6 2023CERTIFICATEofCOMPLIANCE
PAYMENT of SCHOOL FACILITY FEES CITY OF ANAHEIM
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER INFORMATION:
Name:V 41*1400/^^2f4RgZ.C
2 Address:
Phone Number:Home (\Celt(
APPLi^T INFORMATION:
3 Name
Phone Number:Home (Cell(
PROPERTY INFORMATION:
Project Address:
Development Type;()Residential -New
()Single Family
4 {)Commercial:
()Multi-Family Condos/Apartments #of units:
Residential -Room Addition
Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
5 =$Elei Elem.
H.S.$=S H.S.
●ee:$=S =$Equals Equals Total Fee:$
FEE WAIVER:
6 Fees Waived;()Yes {)No If yes,reason:
ACKNOWLEDGEMENT:
^e above respresentations as to square footage are true,Developer/Appiicant agrees that if it is later determined that such respresentations
ar !not true,Certificate shall automatically terminate and the appropriate City/County shall be notified.
Developer/Applicant Signature:
7^
7
y
CERTIFICATION:
This certifies that the above named Developer/Appiicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8
a.■is t
Representative -Anaheim Union High School DistrictDate
AaUAL FEES PAID:9s>ApS^3/?'.32r.Check No.
Check No.Anaheim Union H.S.Drst.
Distribution:Developer/Appiicant,AUHSD Accounting Department,Elementary School District Accounting Department