806 W NORTH ST, B1
3
3
4
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91
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Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-35.20
(714) 999-5454
buj > 20 22 , os 8
CERTIFICATE of M19PUARCE
•ti
PAYMENT of SCHOOL FAC-IiITY FEES
RECEIVED
AUG 2 4 2023
CITY OF ANAHEIM
PLANNING & BUILDING DEPARTMENT
NOTICE: The 90-day period in which you may protest the fee described herein will begin on the date this fe, 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 requis.te notice, the 90-day protest period
began at the time your project was approved. Returned checks (NSF) are subject to a $30.00 administrativ.a fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
LP i 1
Anaheim Union High School.District
OWNER INFORMATION -
Name:Name: ovY.i lU���hn(Aw FA
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Address: w� �. `�f l y ��
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Phone Number: Home (� I I�) �� .� ` _%ii(pti Cejl C7I4) '8y 3— 9D I I
APPLICANT INFORMATION:
Name:
Phone Number: Home (I 1q) r— Cell (1q) g j^
PROPERTY INFORMATION:
Project Address: 2U& Norfk) ftmVem ) � �f �w�/
Development Type: ( )Residential - New ( )Re�!-Room Addition -( )Commercial:
( )Single Family ( ) Multi -Family Condos/Apattments#of units:
Project Name:
COMMERCIAL:
RESIDENTIAL:
Total Square Footage:
ot0l,Square gootage:
Multipiled by Current Rate
Multipil bVurrent Rate
Elem.$ _$
Elem.$.c2•"5 =$
H.S. $ =$
- H.S. $a•3`13 =$ 06.9a
Equals Total Fee: $ _ $
Equals Total Fee: $ Y _ $ �gG�• U
FEE WAIVER:,
Fees Waived:( ) Yes (✓) No If yes, reason: /
ACKNOWLEDGEMENT: ! _�
The above respresentations as to square footage are true, Developer/Applic- �•.t agr�,es that if it is later detgrmined that such respresentations
are not true, Certificate shall automatically termi ate d the appr ri n
�Coguunty%"I,bernotified.
Developer/Applicant Signature:��G�f�ca
CERTIFICA?ON:
This certifies that thi, above named Developer/Ap nt oo acility ees n compliance with Ggvernment Code Sections 53080 and
65995.
�'as2_ _
Date ntative - Anaheim Union High School District
ACTUAL FEES PAID:
At*Q&iM 66D $ q00 5 Check No.
Anaheim Union H.S. Dist. $ )D-5.0- Check No. _ 4Y /a
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department