1969 W LULLABY LN (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520 RECEIVED
(714)999-5454
UNLIMITED
MAY 23 2022
CITY OF ANAHEIMplanning&BUILDING 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 wasImposedbytheCityorCountyasaconditionofapprovalforyourproject,and you have received the requisite notice,the 90-day protest periodbeganattheitmeyourprojectwasapproved.Returned checks (NSF)are subject to a $30.00 administrative fee.
Elementary district:RECEIPT NO.:HIGH SCHOOL DISTRICT:
Anaheim Union High School District
1 Act
OWNER INFORMATION:
Name:f^\unaU\Ci Address:_uj w w ■)>i I igiJOsf LA,Hnanfj m r ’rni.azpIJil
Cell Cj
2
Phone Number:Home (
APPLICANT INFORMATION:
Name:L A\vcV0 Uimcj.il aPhoneNumber:Home (
3
Cell (1/^1 if
PROPERTY INFORMATION:
iV-UHlM Ca^^i2Sd'^
Development Type:()Residential -New (X)Residential -Room Addition ()Commercial:
()Single Family ()Multi-Family Condos/Apartments#of units:M\Mxl^\lliA fW\ICir3
Project Address:4
Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Elem.^
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
5 Elem.$,=$
.s.$H.S.
Equals ToJaFF^e:$=$Equals Total Fee:$=$
FEE WAIVER:
Fees Waived:()Yes6 )No If yes,reason:
ACKNOWLEDGEMENT:
The above respresentations as to square footage are true,Developer/Applicant agrees that if It is later determined that such respresentationsnottrue,Certificate shall automatically terminate and the appropriate City/County shall be notified.7 are
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Appilcant has paid school facility fees In compliance with Government Code Sections 5308065995.,,and
8
RepreSentath^Anaheim Union High School DistrictDate
AaUAL FEES PAID:
$Check No.
Check No.
9
Anaheim Union H.S.Dist.$
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department