1940 W ORANGE AVE Bl't)2 nCf
Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
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 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 periodbeganatthetimeyourprojectwasapproved.Returned checks (NSF)are subject to a $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1/
OWNER INFORMATION;
Name:
Address:2 Viill LA●H eg vtcn A V g-fw ^
Phone Number:Hornefim)^'3 A t Cell (1
APPUCANT INFORMATION:
Name:
Phone Number:Home (●??!'i^)A’l
\’«Vs3
)'t Cell(-[;v)anC-C-
PROPERTY INFORMATION:
Mq -c W ●A V £&Project Address;
Development Type:(X )Residential -New ()Residential -Room Addition4 ()Commercial:
{)Multi-Family Condos/Apartments #of units:(X )Single Family
Project Name:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:QdpoTotalSquareFootage:
Multiplied by Current Rate
2/;5 Elem,=$Elem.S
H.S.$=$H.S.
●ee:$EqualsTj =$Equals Total Fee:$=$'
FEE WAIVER:
^Fees Waived;()Yes If yes,reason:
ACKNOWLEDGEMENT:^
The above respresentatlonsas to square footage are true,Developer/Applicant agrees that If it is later determined that such respresentations
'are not true.Certificate shall automatically terminate and the appropriate City/County shall be notified.
Developer/Applicant Signature:/
7CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.28 =,2fepc^sen^lve -Anaheim LJniorrHlfeh School DistrictDate
ACTUAL FEES PAID:
9
Anaheim Union H.S.DIst.
Check No.
Check No.2^yy
Distribution;Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department