1803 E VERDE PL (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
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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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER INFORMATION:
Name:
Address:
Phone Number;Home (7/4l ~7
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Cell(
APPLICANT INFORMATION:
Name:
Phone Number:Home (7/^1
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Cetl(
PROPERTY INFORMATION:
^oe.rcJp £cProjectAddress:
Development Type:()Residential -New {)Residential -Room Addition4 ()Commercial:
()Multi-Family Condos/Apartments it of units:(^Single Family
Project Name:
COMMERCIAL:RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate s^-aV
%p-dy /.5DS~S:Z
5 Elei =S Elem.
H.S.$=S H.S.
Equals TptflfFee:$=S EqualsTotal Fee;$=$
FEE WAIVER:
Fees Waived:()Yes ()u No6
If yes,reason:
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
are not true.Certificate shall automatically terminate and the appropriate City/County shal[
Developer/Applicant Signature:
7 :ified.
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995 $8
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5DateRepresent^ive-Anaheim Union High School District
AaUALFEES PAID:
Check No./^S-
$Check No.9
$Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department