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CITY OF SANTA ANA <br />�f <br />4 <br />Planning and Building Agency � <br />Garden Grove Unified School District <br />Certification of Compliance <br />Payment of School Facility Fees <br />Developer/Applicant LA Va V <br />��]��1,�1 �1 <br />Address L `J I <br />Telephone Numbe <br />Project Location <br />Street Address <br />Number of SqFeet <br />of R <br />Number of Square Feet <br />of Commercial and <br />Industrial Space <br />:3 c <br />OV12 r� vac., <br />v <br />City <br />Now 046 <br />. --�pproved <br />FOR PERMIT ISSUANCE <br />Master iv.THE GOLDEN <br />-i <br />FOUNDED 186 <br />natp <br />ZIP <br />����������.���������������������l�i��s����i��i��l�������►�����s..����rr��w.r�f.rdeems <br />r <br />cro <br />t8 1 Toa 1 <br />x <br />The above representations as to square footage are true. Developer/ <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 />Total $ <br />'Applicant agrees that I*f it is <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 />ZT <br />Date <br />,4s4Ws�.aam�ss�i�i� <br />• <br />Receiptof <br />This certifies that the above -named Developer/Applicant has paid school facility fees in <br />compliance with Government Code Section 65995 and Education Code Section 17620. <br />These fee have been <br />Cash <br />Date <br />Check <br />received from�VG� <br />r <br />� Check No.- <br />d i�wt��� Lie 4k4l-j�w� <br />�'2y) �Dollars � 3, � P� <br />Bank <br />Vt, AAq/� <br />Superintendent Designee <br />Garden Grove Unified School District <br />(714) 6634=6442 <br />9703.69* (Rev 6/14) <br />