723 S WASCO RD^CD20/^2'0\\i2^Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
RECEIVED
JUL 0 6 2022CERTIFICATEofCOMPLIANCE
PAYMENT of SCHOOL FACILITY FEES CITY OF ANAHEIM
PLANNING &BUILDING DEPARUIEN^
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 periodbeganatthetimeyourprojectwasapproved.Returned checks (NSF)are subject to a $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District »<VA-
OWNEMTNFORMATION:
Name:
,2
Phone Number:Home(Cell -gile
APPDCANfTNFbirWAtlON:
HO/V VO3Name:
Phone Number:Home(Cell(
PROPERTY INFORMATION
Project Address:3 Wk^Cp Pr-L,Development Type:{)Residential -New (Residential-Roorn Addition4
()Commercial:
()Multi-Family Condos/Apartments #of units:{)Single Family
Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
ElenTj,,$.^
S
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
/■
H.S.
5 =$Elem.$
=$
Equals Tot9i-fM:$=s Equals Total Fee:$=$_
FEE WAIVER;
^Fees Waived:()Yes
The above respresentations as to square footage-areTfOSTf^are not true,Certificate shall automatic^fyterminate an^
No If yes,reason:
iveloper/Applicant agrees thaUtiHSla^ter determined that such respresentations
lall be notified.ipropriate City/Coui
Developer/Applicant Signature:z:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8 \
le.3^
ptat]^-Anaheim Union High School DistrictDateR^
AaUAL FEES PAID:
Anaheim Union H.S.DIst.
s Check No.
Check No.S /,^3^
Distribution:Developer/Appiicant,AUHSD Accounting Department,Elementary School District Accounting Department