1216 S FEATHER ST (6)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92S03-3520_1\/crn(714)999-5454 R E C EIV t U
may 0 9 2022
UHLIII/im
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY
CITY OF ANAHEIM-RUILDING DEPARTMENT
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 DISTRia:HIGH SCHOOL DISTRICT:
Anaheim Union High School District
RECEIPT NO.:
1
OWNER INFORMATION:
Name:
2 Address;.V;'S
CellPhoneNumber:Home (
APPLICANT INFORMATION:
Name A3 '<'\
Cell njMiPhoneNumber:Home(
PROPERTY INFORMATION:
Project Address:\y %
Development Type:Residential -New (}Residential -Room Addition
()Single Family
4 ()Commercial:
()Multi-Family Condos/Apartments#of units:
Project Name:
1DENTIAL:COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
Elenv^
$
Total Square Footage:
Multiplied by Current Rate ^=5 46/'7-=$Elem.5
=S H.S.
Equals Total Fee:$=$_^e:$=$EqualsTi
FEE WAIVER:
Fees Waived:()Yes6 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 tqi^iinate aijd the appropriate City/County shall be notified.
Developer/Applicant Signature:
7
7
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995 /
8
School DistrictDate
ACTUAL FEES PAID:4 6^/9 Check No.\SM
Check No.\
$9 $4AnaheimUnionH.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department