1207 E FLOWER ST BAnaheim 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 period
began at the time your project was approved.Returned checks (NSF)are subject to a $30.00 administrative fee.
ECEIPTNO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1
OWNER TNF&RMAtlON:
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Name:
Address:2
Phone Number:Home (
INFORMATION:
1 Name:3
Ceil (7/^Phone Number:Home {
PROPERTY INFORMATION:
S-/-Ak<;AItolCPUiProjectAddress:
Development Type:Residential -New {)Residential -Room Addition
'e/
4 )Commercial:
()Single Family
Aou
()Multi-Family Condos/Apartments#of units:
Project Name:r
COMMERCIAL:RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
Total Square Footage:
Multiplied by Current Rate
AesDAUI+S^Equals Total Fee:$
5 Elem.$^=S Elem.
=s H.S.
=s=sEqualsTotalTeef
FEE WAIVER:
Fees Waived:!)Yes (\^No6 If yes,reason:
t»T >*-●
Tfie above respresentations as to square footage are true,Developer/Appiicant agrees that if it is later determined that such respresentations
a/e not true.Certificate shall automatically terminate and the appropriate City/County shall be notified.7
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995^/^/u>j8 '-~,xI
resentative -Ananeim Union High School DistrictDate
ACTUAL FEES PAID:
Anaheim Union H.S.Dist.
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s /.^93,
J>Check No.
Check No.
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Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department