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CITY OF SANTA ANA <br />Planning and Building Agency <br />Name (1=it.1. MI. I ast) <br />Certificate of C'omplience <br />Payment of School Facility Fees <br />�atitn Ann Vnified School District <br />1 elct►ht►nc <br />M orco Get ierrer. <br />Project ,Nddrr%-. <br />2522 W <br />City, ~talc, 7.ir t `►Xte <br />Sa��ta <br />Na r»c (1~ irsL NI 1, Last) <br />Camden P1 <br />Ai,x,a. , CA q2-404 <br />OR PER'PVl�T�9SU�ANCP <br />Date: <br />(o- 120y <br />TnnctMarcel Numher <br />1010 22 325 <br />I elephone <br />a Use of' Rudding (check) Type of Project (check) <br />Residential I Commercial ❑ Senior Housing ❑ New ❑ Addition ❑ Alteration d <br />raescription of Project <br />ADU Gar a Conversion <br />Number of Square Feat of <br />Residential Space _ 1443.88 Sq.Ft x S <br />\umber of Square Feet of <br />Commercial Space <br />Sq.Ft x S <br />6.1+ <br />(Dev. Fee) <br />(Dev. Fee) <br />Total s 2, 29 4.810 <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 C ountti 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 tee. <br />Applicant Name (Please Print) <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 />SantaNna <br />ol <br />I <br />nifted . ch0011 bistrict : uthorized Representative <br />D/S'nU811170N <br />*A* - C40CM00 <br />co wry-4ppok%ml <br />PM - FacMa <br />Date <br />