824 S. DUNE ST, CE
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Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714) 999-5454
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.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
LD (33
Anaheim Union High School District 34
OWNER INFORMATION:
n
Name: , ,05 t! V ADIZ—ic�rWv'C
Address: S. DU i& ST— ANIa elm CA
Phone Number: Home ( ) Cell (71 y) 2 i9Z1— ?i %9 `1
APPLICANT INFORMATION:
Name:
Phone Number: Home ( ) Cell ( )
PROPERTY INFORMATION:
Project Address: 'g 2,� S nOUdC Sr #G ANP,}j 6INA ( A 0)'2-&
Development Type: ( Residential -New ( ) Residential - Room Addition ( ) Commercial:
( ) Single Family ( ) Multi-Fami y Condos/Apartments # of units:
Project Name: %v23 ^O ss
COMMERCIAL:
RESIDENTIAL:
Total Square Footage:
Total Square Footage: 4.27
Multiplied by Current Rate
Multiplied by Current Rate
Elem. $ _ $
Elem. $ ���5/ = $ 103d P- Lo
H.S. $ =$
H.S. $o� r7-�✓ =$ ib,)a-(off
Equals Total Fee: $ _ $
Equals Total Fee: $ _ = $ CX46 -54
FEE WAIVER:
Fees Waived: ( ) Yes (�o If yes, reason: -
RKNOWLEDGEMENT:
The above respresentations as 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 C' County shall be notified.
Developer/Applicant Signature: ('h
CERTIFICATION:
This certifies that the above named Develo cant has paid sc compliance with Government Code Sections 53080 and
65995.
Date a ive -Anaheim Union High School District
ACTUAL FEES PAID:
JkN�t+;i M Q.S.D. Check No. 1983r7113(09
Anaheim Union H.S. Dist. $ Check No. 19g 35133/of3
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department