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CITY A <br />AM <br />A <br />o � Certificate of Compliance Pla � <br />� Payment of School Facility Fees <br />`°scHoo�°Santa Ana UnifiedS chool District � '+' ' I ' ed , <br />N 1%wolv I It I M� 1 11 1w <br />INV AL �-M <br />Name (First, MI, Lastsop <br />) Tele honeORNOW iiiiiiiiiiiiiijllllllll <br />C do <br />Master ID: <br />Tract/Parcel Num er p 1111111111110V <br />Project Addressr)Q411 — — — — — - - so <br />14 <br />City, State., Zip Code <br />Name (First, MI, Last) Telephone <br />Use of BueBuildingcheck) Type o Project (check) <br />Residenti Commercial ❑ Senior Housing ❑ Nev� Addition ❑ Alteration ❑ <br />Description of Project <br />Number of Square Fee <br />dential Space Sq.Ft x $otaResi(Dev, Fee) <br />Number of Square Feet of Total $ <br />Commercial Space Sq,,Ft x $ <br />(Dev. Fee) <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 />L\ ryN <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 o the G emment Code and Education Code. <br />Sant Ana Unified School District Authorized Representative Date <br />DISTRIBUTION <br />White -City/County <br />Canary -Applicant <br />Pink -Facilities <br />