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1808 W CHALET AVE, B
Anaheim Union High School District SO]Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520 (714)999-5454 UNUMITEO YOU O CERTIFICATE of COMPLIANCE PAYMENT of SCHOOL FACILITY FEES H tMM ixk mwiei NOTICE:The 90-dav period in which you mayr protest the fee described herein will begin on the date this eeispai .'e -e v^os imposed by the City Of County as a condition of approval for your project,and you have received the requisite notice,e ay pro .s peno began at the lime your project was approved.Returned checks (NSF)are subject to a $30.00 administrative fee. HIGH SCHOOL DISTRICT: Anaheim Union High School District ELEMENTARY DISTRICT:RECEIPT NO.; 1 ^9^3 OWNER INFORMATION; Name:OiNDN HUSNH »TUUIA IRAN Address:W-GHAtCT AVR.AKAWfeiM.oft Cellfflu)i?2a -'55A^ 2 Phone Number:Home( APPLICANT INFORMATION: Name:OUL(A TRAN3 CelUl-ii||-?22-g5'35:Phone Number;Home{ PROPERTY INFORMATION: Project Address:W-GHAL£T AV£.UNIT B ■ANAH&IH ■(_A Development Type;(X)Residentpl^New ()Residential -Room Addition )Single )Multi-Family Condos/Apartments #of units: Project Name:fLAN CHPXk:NUM&feR'●BLDIOZi -0 5_H-S3 {)Commercial:4 ( RESIDENTIAL:COMMERCIAL: Total Square Footage: Multiplied by Current Rate Elep<<; S f3o~oTotalSquareFootage: Multiplied by Current Rate g’W,’SoElem.=s5 H.S.=s =sEqualsTotalFee:$=SEqualsToj*FFee:$ FEE WAIVER: Fees Waived:()Yes V)6 If yes,reason:No TACKNOWLEDGEMENT; 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 temiinata^d th^appropriate City/County shall be notified. Developer/Applicant Signature: 7 ©CERTIFICATION: Tnrs certifies that the above named Oeveloper/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 53995. 8 U lhlS2. resenlative -Anaheim Union High School DistrictDate AaUAL FEES PAID: $..2. /syCheckNo. Check No. 9 Anaheim Union H.S.Dist. 1 Distribution:Developer/Applicant,AUHSO Accounting Department,Elementary School District Accounting Department I