1323 W LASTER AVE, BAnaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
RECEIVED
FEB 1 h 2023
UNLIMITED
CITY OF ANAHEIM
PLANNING &BUILDING DEPARTMENT
I ●rxxi M-i CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
NOTICE:The 90-dav 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 $30.00 administrative fee.
HIGH SCHOOL DISTRICT:
Anaheim Union High School District
RECEIPT NO.:ELEMENTARY DISTRia:
1
OWNER INFORMATION:
Name;
Address:2
Phone Number:Home 77 ^^Cell (,
APPLICANT INFORMATION:
'^7 _
Name:3
Cell(Phone Number:Home
PROPERTY INFORMATION:
/%2S 1%u/.Project Address;
Development Type:^j,.('<l Residential -New4 ()Commercial;)Residential -Room Addition
(1 Multi-Family Condos/Apartments U of units:()Single Family
Project Name:
RESIDENTIAL;COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate //>?A5=S Elem.5Elei
H.S.S_.H.S,
Equals Total Fee:$=$=Sfe:SEqualsTi
FEE WAIVER:
Fees Waived:()Yes (6 If yes,reason;No
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,De^loper/Applicant agrees that if it is later determined that such respresentations
are not true,Certificate shall automatically terminate and7 ;jate City/County shall be notified.
Developer/Applicant Signature;
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995,r8
-Anah^Union High School DistrictDate
AaUAL FEES PAID:
s Check No.
Check No.
c»9
$Anaheim Union H.S.Dist.L7-^
Distribution;Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department