1633 W LINCOLN AVE (2)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
<,n o(<,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 wasimposedbytheCityorCountyasaconditionofapprovalforyourproject,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 $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District
[OWNER INFORMATION:
Name:
'Five ym-t Ut.3ys Irv/Kf,C/hPhoneNumber;Home(^^?907-~^11^'
/O
APPLICANT INFORMATION:^e x y /?i /I Name:luAlJC Phone Number:Home^^*^')^^7 -Cell (?*4^~~^!i *4"
PROPERTY INFORMATION:
Project Address:
Development Type:{
r
Residential -New ()Residential -Room Addition
()Single Family
{)Commercial:
[\/]Multi-Family Condos/Apartments #of units:^V
Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
Elem.SH.S..$^>0H =s/^^7S
s Elem.$_
H.S.$
=$
=$
Equals Total Fee:$=$Equals Total Fee;$
TFEEWAIVER:
IFees Waived:()Yes )No If yes,reason:
ACKNOWLEDGEMENf:
pie above respresentatlons as to square footagirarenottrue.Certificate shall automati^y tern
'Oeveloper/Appllcant Signature:
^re true,Developer/Applicant agrees that if it is later determined that such respresentatlons^te an^the Appropriate Ci^/County shall be notified.
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school ftcility fees in compliance with Government Code Sections 53080 and
65995 r95..I8
ajjeinr^Date Representative -Ion High School District
[ACTUAL FEES PAID:
Check No..
Check No.
9
Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department