739 N PINE ST BAnaheim Union High School District
501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-350
(714)999-5454
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES F71-p�_VO373
NOTICES: (1) The 9D-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 foryour project, and you have received the requisite notice, the 9D-day protest period began at the time your project was approved (A
returned check (NSF) is subject to a $30.00 administrative fee); (2) you have the right to request an audit of Developer Fees per Gov. Code § 66023; (3) you
have the right to file a written request for mailed notice of the District's Board meeting to review the Developer Fees Annual Report; and (4) The Developer Fees Annual
Report and supporting documents are available at: httl2s://www,auhsd.us/DistrigtiDepartment/14195-Facilities.
RECEIPT NO.:
ELEMENTARY DISTRICT:
HIGH SCHOOL DISTRICT:
Anaheim Elementary
AN
Anaheim Union High School District
school District
OWNER INFORMATION:
a
Name: C,-t:Ct CO C 7 0 NrA I_&7
Address: Cr /s i . / tie !ET- Q AJA Al s ✓I %d q 7,l
Phone Number Home ( ) Cell (7/Jt) 040 - 56.51
> APPLICANT INFORMATION:
Name:
Phone Number: Home( ) Cell ( )
I PROPERTY INFORMATION:
J
Project Address: 739 N. PINE ST. ,#B, ANAHEIM
Development Type: (X) Residential -New ( ) Room Addition ( ) Commercial:
( ) Single Family Multi -Family Condos/Apartments # of units:
Project Name: 2024-00373 ATT ADU
COMMERCIAL:
RESIDENTIAL:
Total Square Footage:
Total Square Footage: 760
Multiplied by Current Rate
Multiplied by Current Rate
Elem. $ _ $
Eler $ 2.585 = $ 1,964.60 _
$ _$ _
H.S. $ 2.585 =$ 1,964.60
Equals Tot : $ _ $
Equals Total Fee: $ _ $
FEE WAIVER:
Fees Waived: ( ) Yes (X ) No If yes, reason:
ACKNOWLEDGEMENTS:
The above respresentations as to square footage are true, Develper/Applicant agrees that if it is later determined that such
respresentations are not true, Certificate shall a omatically �inate and the appropriate City/County shall be notified.
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Develper/Applicant has paid school facility fees in compliane with Government Code Sections
53080 and 65995.
Date Repres ativ - Anaheim Union High School District
ACTUAL FEES PAID:
1.lm Elementary
$ 1,964.60 Check No. 3t>32pp0 i
School
school District (Aesn)
2.Anaheim Union A.S. Dist. $ 1,964.60 Check No.41
3
(AUHSD)
oc