Laserfiche WebLink
CITY OF SANTA ANA <br />Nam first, M1, Last) <br />_11 <br />Project Address <br />City State., lip Code <br />Name (First, M1, Last) <br />icate of Compl11 <br />iance <br />Payment of School Facility Fees <br />CO <br />Santa Ana Unified School District <br />aw <br />me <br />Use of Building (check) <br />ResidentiC2Commercial ❑ <br />Description of Project <br />Number of Square Feet of <br />Residential Space <br />Number of Square Feet of <br />Commercial Space <br />Senior Housing ❑ <br />Telephone <br />Planning and Building Agency I <br />W <br />rle§ <br />- - I- I- - — W� <br />FOR PERMIT ISSUANCE <br />aster ID: <br />Pat <br />Tract/Parcel Number <br />\ ('" \_ \r I <br />Telephone <br />Type of Project (check) <br />NeNv'r"22,1 Addition ❑ Alteration ❑ <br />Sq. Ft x $ a V;_ <br />(Dev. Fee) <br />Sq.Ft x $ <br />(Dev. Fee) <br />Total $ <br />Total $ <br />VA I <br />The above representations as to square footage are true. Applicant agrees that if it is later <br />representations are not true, then this certificate shall automatically terminate, and the appropriate <br />notified. Applicant is hereby noticed that any party filing a protest regarding the imposition <br />Government Code Section 53080 111ust do so within 90 days from the payment of the fee. <br />i <br />ar�+a �eryJ � <br />ApplicaFAName (Please Print) <br />This certifies that the above -named Applicant has paid school facility fees in c <br />sections of the Govemment Code and Education Code. <br />Santa' <br />W s M Y SWAM — <br />DISTRIBUTION <br />White - cilylCounty. <br />Ca Wn1- Appl icvltr <br />Pink - Facilities <br />Representative <br />determined that such <br />City/County shall be <br />of fees pursuant to <br />0 r <br />119 <br />7/1 / ;?Clz <br />Date <br />ompliance with all existing and applicable <br />2S <br />Date <br />