2054 W ORANGE AVE, B7
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Anaheim Union High School District B07,07,/ - o 594014rJ 35O
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714)999-5454
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOLFACILITY FEES
NOTICE: The 90•day period in which you may protest the fee described herein will begin 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 receiv the requisite notice, the 90-0ay protest period
began at the time your project was approved. Returned checics (NSF) are bject to a $30.00 ad inistrative fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGHS D ICT:
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Anaheim Union High School District / E
OWNER INFORMATION:
Name: y ye
Address: 6-0 5 N U/ Gy'at n o e Q de A ,t?, A CA q 2'50/1
Phone Number: Home (71,4) 3 0'0 5015 Cell (7[4) 3 dO Sci 15
APPLICANT INFORMATION:
Name: JU.✓,PTV l�.l� N -I;
Phone Number: Home (71-f) �c,1r/ 5u l Cell ( 714) ?aO SG/ 5
PROPERTY INFORMATION: —0 g
Project Address: %5C9yu"5e AVe Qb4k24 i A 9°7--$O'y
Development Type: (✓TResidential -New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments fi of units:
j� _
Project Name: AT1>11, %: '
COMMERCIAL:
RESIDENTIAL:
/ ;Z oo
Total Square Footage:
Total Square Footage:
Multipiled by Current Rate
Ele =$
Multiplied by Current Rate ��11
Elem.$a"'395=$
H.S. $ _ $
H.S.9S
EqualsT ee:$ _$
Equals Total Fee:$ _$
FEE WAIVER:
Fees Waived: ( ) Yes ( l0 If yes, reason: -
ACKNOWLEDGEMENT:
h above respresentations as to square footage are true, Developer/Applicant agrees that if it is later determined that such respresentatlons
are of true, Certificate shall automatically terminat nd th ppr riate County 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. / \
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Date Ile rese ative -Anaheim Union High School District
ACTUAL FEES PAID:
_P-,_ O $ 'a' g � 7` D� Check No.
Anaheim Union H.S. Dist. $ �5?, - Check No. l 0 3
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department