935 N. KEYSTONE ST (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER INFORMATION:
Name:
2
■'‘SiLcAyPhoneNumber:Home (Cell (^1^)
APPLICANT INFORMATION:
j±1 VcdeQdb3Name:
ceiiPfm)1PhoneNumber:Home (
PROPERTY INFORMATION:
Project Address:AJ.6-L CA <?78C-l
Development Type;(}Residential -New 4 ^^Residential -Room Addition )Commercial:
{)Single Family
4
{)Multi-Family Condos/Apartments #of units:
Project Name:
COMMERCIAL:RESIDENTIAL::(gZ-2-
j2^=sJ2M:^s7.oU =s |'2Ap*g.g'S'
Total Square Footage;
Multiplied by Current Rate
Total Square Footage
Multiplied by Current Rate
5 Elem.$_
H.S.$
=S Elem.$
=s H.S.
Equals Total Fee:$Equals Total Fee:$=S =$
FEE WAIVER:
Fees Waived:()Yes6 If yes,reason;
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,Devel(^j^/Appy\cant agrees that if it is later determined that such respresentations
are not true,Certificate shall automatically termin:
Developer/Applicant Signature:/Qj^,
7 ipropriate (:ity/County shall be notified.the
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.^io\2<rz\8
Representative -Anahffm Ur^n High School DistrictDate
ACTUAL FEES PAID:(m$Check No.
Check No.
9
Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department
thdoc/developerfee/coc