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PL 41 <br />'.1 9;0 <br />Planning a <br />ui <br />■ <br />ing A <br />Name (First, M [, Last) <br />Project Address <br />City, State, Zip Code <br />Name (First, M1, Last) <br />Certificate of Compliance <br />Payment of School Facility Fees <br />Santa Ana Unified School District <br />H e cA-G r a e n c G <br />1232 G Sycovnore..,, <br />5c3n+cL- A"zL-, GA 9Z+O"i <br />Use of Building check) <br />Residential Commercial El Senior Housing ❑ <br />Description of Project <br />AAr�ed <br />FOR PERMIT ISSUA <br />Telephone Master ID: <br />-Data: <br />4 — f -9.14 <br />Tract/Parcel Number <br />102123400 <br />Telephone <br />Type of Project (check) <br />NewEl AdditionEl Alteration[ <br />Go-ra-cte -Fo ADu Ga�x1-�-��Sidn <br />Number of Square Feet of <br />Residential Space W30 Sq.Ft x <br />$ 5.i'+ <br />(Dev. Fee) <br />Number of Square Feet of <br />Commercial Space Sq.Ft X $ (Dev. Fee) <br />Total $ 2,2 2 S, 10 <br />Total $ <br />presentations <br />Theabove re as to square footage are true. Applicant agrees that if it is later adetityCr/County shall be <br />ined that such <br />representations are not true, then this certificate shall automatically terminate, and the appropriate <br />notified. Applicant is hereby noticedthat <br />filinga 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 />Ci Yve-N C V') I <br />Applicant Name (Pleoe Print) <br />AA <br />l <br />Sogname <br />D to <br />e-named A licant has paid school facility fees in compliance with all existing and applicable <br />This certifies that the aCode and Education Code.sections of the Governrn <br />S <br />Santa Unified School Distric <br />DISTRIB U7VN <br />White - CUYICaunry <br />Canary - Applicant <br />Pink - Facilities <br />Authorized <br />epresentative <br />Date <br />