Loading...
1613 E. Santa Ana St. ~ Anaheim Union High School District 501 Crescent Way, P.O. Box 3520, Anaheim, CA 92803-3520 (714) 999-2188 (714) 520-5741 FAX CERTIFICATE of COMPLIANCE PAYMENT of SCHOOL FACILITY FEES NOTICE: The gO-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. Rd'&NV'/ Elementary District: 4~~j Il7.JQeZ /~/(;j C. High School District: Anaheim Union High School District Owner Information: Name: Address: Phone Number: ( ;;Z...e /lJ,4.v?:>O ....s r)VT;9 gJu e6 /f1J, Si-- Applicant Information: Name: ~~ /OJ-.- ~ Phone Number: ( Property Information: Address of Project: Development Type: Project Name: Type: \;5~ ~ ~ '.', ] Residential - New [ Y Residential - Room Addition [ ] Commercial [ ] Single Family Multi-Family Condos/Apartments - # of units: Commercial: Total Square Footage: Multiplied by Current Rate: Elem. $ H.S. $ Residential: EqualS Total Fee: [ J l~l~oonly / / .>s.- Elem. $ /; ~$I.2'1 5 II 0 H.5. $ /;.z..;;' $I c;l-1 :3 " d?.:< V -$6Z'iY'?-7. / EqualS Total Fee: $ =$ =$ -$ [ ] Level 1 [ ] Levei 2 - ACSO Only Total Square Footage: Multiplied by Current Rate: $ Fee Waiver: Fees Waived: Yes No If yes, reason: Acknowledgement: The above representations as to square footage are true. Developer/Applicant agrees that if it is later determined that such representations are not true, Certificate shall automatically inate and the appropriate City/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. /ljlf!),S- Date / / Representati~e~n High s~ ::7 Anaheim Union H.S. District $ $ /0<.13.&0 1~"l3.67J Check No. Check No. ;)..011 ~/ CZ Distribution: City/County - Developer - Accounting . Elementary District H?/ 115 U.