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Anaheim Union High School District
501 Crescent Way, P.O, Box 3520, Anaheim, CA 92803-3520
(714) 999-5454 RECEIVED
CERTIFICATE of COMPLIANCE AUG 0 8 2022
CITY C.
ANAHEAI
PAYMENT of SCHOOL FACILITY FEH' r;N��� a ai a NG D=r=,RT','eN-
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.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
J g,
A
Anaheim Union High School District
OWNER INFORMATION: _
Name: IY��
Address: 2 262 X2,44M-7�
Phone Number: Home ( ) Cell (-M4) 1 ' h !
APPLICANT INFORMATION
Name: i,\.�
Phone Number: Home Cell
PROPERTY INFORMATION:
11 "(1�
ProjectAddress: l� (/ ✓' `l�i1G'��1, 6,ff I� ��
Development Type: ( ) Residential -New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family_ ( ) Multi -Family Condos/Apartments q of units:
Project Name:—�
COMMERCIAL:
RESIDENTIAL: j
Total Square Footage:
Total Square Footage: 1 ('�,?�7(JJMultiplied
by Current Rate
Multipiled by Current Rate34SEle
9,H.S.
= $
$=$
Elem. $9'Y
H.S. $ _ 2. ez
Equals T ee: $ _ $
Equals Total Fee: $
FEE WAIVER:
Fees Waived: ( ) Yes M ) No If yes, reason:
ACKNOWLEOGEMENT.
The above respresentations as to square footage re true, Developer/ plicant a rees that if it is later determined that such respresentations
are not true, Certificate shall automatically er „Ina e and the approp, to City unty shall be notified.
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.
Date Represe tatat�e -Anaheim Union High School District
ACTUAL FEES PAID:
$ �—�� S/ y. %✓C Check No. /
Anaheim Union H.S. Dist. $ �� /'S/,z , Q n Check No.
uiscnounon: ueveioper/Appucant, AUHSD Accounting Department, Elementary School District Accounting Department