2241 E. ALDEN AVERECEIVED
MAY 1 7 2022
Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
CITY OF ANAHEIM
planning &B'.ilLO’NG DEPARTMENTCERTIFICATEofCOMPLIANCE
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 $30.00 administrative fee.
ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District
RECEIPT NO.:
OWNER INFORMATION:
Phone Number:Home (y((^l
Address:
Cell (
APPLICANT INFORMATION:
Name:77'^X 7/g^
Phone Number:Home(Cell
PROPERTY INFORMATION:
Project Address:
Development Type:()Residential -New
{)Single Family
g .A-LOgN Ai/E.AfJAA-aM PA
(r ●Residential -Room Addition ()Commercial:
r
D
{)Multi-Family Condos/Apartments #of units:
Project Name;
RESIDENTIAL:COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Elem.
Li30\Total Square Footage:
Multiplied by Current Rate
Elem.$
s:3 V,zaG».o^
=s
.S.$=$H.S.
=$Equals Total Fee;$Equals $=S
FEE WAIVER:
Fees Waived:()Yes Y>]If yes,reason:No
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 ternjij
Developer/Applicant Signature:
and the appropriate Clty/County shall be notified.
C
2
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.C
lxN3e.erese^tive -Anaheim Union High School DistrictDate
ACTUAL FEES PAID:
$L 3 Check No.
Check No.Anaheim Union H.S.Dist.
Distribution;Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department