1569 S DISNEYLAND DR3
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Anaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520
(714)999-5454
ELD 2cz
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 $30.00 administrative fee.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
Anaheim Union High School District
OWNER INFORMATION: /
DAf��t�G eesAUpT--
Name:
Address: /SG `j 13 i� IeWl Q/-i ✓e
Phone Number: Home ( ;• _ Cell (�&7) B3- 31 0-7
APPLICANT INFORMATION:
Name: 611,0 I Es 11ZAl ift a 06 s
Phone Number: Home ($T7) i 33-31 07 Cell 85J j _ 7-33-3%M
PROPERTY INFORMATION:
/
Project Address:
Development Type: ( ) Residential -New ( ) Residential -Room Addition X) Commercial:
( ) Single Family ( ) Multi -Family Condos/Apartments ff of units:
Project Name: &rh% i2! eA,&17—
COMMERCIAL:
L:
Total Square Footage:
Total Square Footage: 10% 1
Multipiled by Current Rate
Multipiled by Current Rate
�`3 % / /
Elem. $ _ $
Elem. $-- $ •
H.S. $ _$
H.S. S -�'7 =$a7 .7
Equals Total Fee: $ _ $
Equals Total Fee: $ [ = $
FEE WAIVER:
Fees Waived: ( ) Yes (� If yes, reason:
ACKNOWLEDGEMENT:
The above respresentations as to square footage are tr D v oper/Applicant agrees that if it is later determined that such respresentations
re not true, Certificate shall automatically ter late appropriate City/County shall be notified.
Developer/Applicant Signature: !h
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facilityfees in compliance with Government Code Sections 53080 and
65995.
U 3 23
Date Representative An ei n Union High School District
ACTUAL FEES PAID:
AESD ' ! ��,y a 7LI•7 "! Check No.
Anaheim Union H.S. Dist. $ L{ ZQU- 7 % Check No. Sa87d
Distribution: Developer/Applicant, AUHSD Accounting Department, Elementary School District Accounting Department