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L <br />* A6 <br />L <br />l <br />t• � r. <br />Developer/ <br />Address <br />Applicant <br />2000,L� <br />Telephone Number <br />Project Location <br />OFFICE USE <br />Garden Grove Unified School District <br />Certification of Compliance <br />Payment of School Facility Fees <br />�i�U LL.�/arkN►-�� C,r <br />W -gI 603 <br />Street Address <br />rvin� <br />City <br />FU <br />d <br />Ald <br />�1 t <br />y <br />Master ID.THE GOLDEN <br />FOUNDED IR69 <br />Date: <br />G� �lZ�a3 <br />ZIP <br />Elem. School Int. School High School Thomas Map No. <br />■��r���rrr�rr.s�ww��w��.��rr�raw�rwi�wrA�str�rr►w�w�w�r ww����w��rrrrr�ww���rsrr■��w�r�rMWIN" wW mmmas MMMMI1YYYYwAWY�1��w�r����Y�#�1r1����� <br />Number of SqFeet07 ID <br />Ll <br />of oa <br />• <br />Number of Square Feet , — <br />of Commercial and � <br />moo <br />Industrial Space x Total $ <br />The above representations as to square footage are true. Developer/Applicant agrees that if it is <br />later determined that such representations are not true then this certificate shall automatically <br />terminate and the appropriate City/County shall be notified. <br />Applicant is hereby noticed that any party filing a protest regarding the imposition of fees <br />pursuant to Government Code Section 65995 and Education Code Section 17620 must do so <br />within 90 days from the payment of the fee. <br />Date <br />Developer/Applicant <br />rr��.rrrrt,rrrw�YYr�aw.�rwr•er�wslr��awrwY��1l�A�wr>trw�r�r.wrs.�YYrr..r�rr■ns..�r�rrsr....�rr...r.r...�.�.��..�r...�r��rarrr..�r��.rrrrrw�r�r�1•wY�1rlrR+wYwYtiitfiam■wmoAA1flfteow4wriwMrNKrWlw&"r-Y� <br />Receipt <br />of Pay <br />This certifies that the above-namedDeielOper/Applicant has paid school facility feesIL <br />in <br />compliance with Government Code Section 65995 and Education Code Section 17620,, <br />These fee have been received from <br />Cash <br />Check V <br />l Z1,Q <br />Date <br />it -At r <br />Check No. <br />or <br />Ban <br />ars $_ <br />r <br />rin esigi <br />Garden Grove Unified School District <br />(714) 34w6442 <br />70 <br />I Cy <br />Ilk <br />. <br />(_ 440, <br />_ <br />r f <br />r_ <br />I <br />I <br />f <br />F <br />h <br />- <br />tir <br />f <br />r <br />_ <br />+p <br />4u i <br />J� M <br />,I <br />4 <br />9703,.69* (Rev. 6/14) <br />