Laserfiche WebLink
Name (First, Ml, Last) <br />Projefctt Address <br />State, `Lip Code <br />L <br />Name (First, M 1, Last) <br />Certificate of Compliance <br />Payment of School Facility Fees <br />Santa Ana Unified School District <br />t, <br />Use of Building (check) <br />ResidentiaM Commercial ❑ Senior Housing ❑ <br />of Project <br />Number of Square Feet ofrr ,�,SJ_ <br />Residential Space lS 3 Sq.Ft x S <br />Number of Square Feet of <br />Commercial Space Sq.Ft x $ <br />Telephone <br />� k�_A - <br />CITY OF SANTA ANA <br />Planning and Building Agency <br />Appra'v.e§4 <br />FOR PERMIT ISSUANCE <br />ster <br />Tract/Parcel Number <br />Telephone <br />Type of Project (check) <br />New ❑ Addition ❑ Alteration ❑ <br />(Dev. Fee) <br />(Dev. Fee) <br />Total S <br />Total S <br />The above representations as to square footage are true. Applicant agrees that if it is later determined that such <br />representations are not true, then this certificate shall automatically terminate, and the appropriate City/County shall be <br />notified. Applicant is hereby noticed that any party filing a protest regarding the imposition of fees pursuant to <br />Government Code Section 53080 must do so within 90 days from the payment of the fee. <br />Guadalu e `�I�lern�n�,e.z- 1-2� -2-5 <br />Applicant Name (Please Print) Date <br />Signature <br />This certifies that the above -named Applicant has paid school facility fees in compliance with all existing and applicable <br />sections of the Government Code and Education Code. <br />Sa Ana Unified School District A t rized Representative Date <br />D1STRIBLTI0A1 <br />White - City/County <br />Canary -Applicant <br />Pink - Facilities <br />