2308 W VALDINA AVE (5)Anaheim Union High School District501CrescentRO.Box 3520,Anaheim,CA 92803-3520 12X^0 ILC^Z.O ~D^
(714)999-5454
UNLIMITEDYOU
RECEIVED
MAY 1 6 2022CERTIFICATEofCOMPLIANCE
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
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
ELEMENTARY DISTRICT:RECEIPT NO.:
1
OWNER INFORMATION:
Name;
Address:
Phone Number:Homei']j^-l
iX)--brnkm^-oh ^'Uo\
Cell (714)'2AC1 ~
2
APPUCANT INFORMATION:
Name;
Phone Number:Homef7J^)
-yamsop ,^lc<uaK3
Cell r/14'1
PROPERTY INFORMATION:
Project Address:(A)'A\y^-'/VlPL'KA^tlA.'CA
Development Type:()Residential -New
( )Single Family
Project Name:JD 2X)Xf)-03
()Commercial:)Residential -Room Addition
{ )Multi-Family Condos/Apartments # of units:
4
RESIDENTIAL:COMMERQAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate
.^^0^--i
Eiem.= $Elem.$-+rsr^$5
H.S= $
= $Equals Total Fee:$= $Equals Totaj..Ee^5
FEE WAIVER:
Fees Waived:( )Yes
ACKNOWLEDGEMENT:^
The above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentationsandtheap^^priate City/County shall be notified.
3 If yes,reason:No
1 not true.Certificate shall automatically terr^
Developer/Applicant Signature:
are
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance
65995.
with Government Code Sections 53080 and
Represfefl^ativ^-Anaheim Union High School DistrictDate
AaUAL FEES PAID:ZllCheckNo.
Check No.Anaheim Union H.S.Dist.
Distribution;Developer/Applicant.AUHSD Accounting Department.Elementary School District Accounting Department
BLD2020-05109