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CITY OF SANTA ANA <br />Planning and Building Agency <br />Developer/Applicant <br />Address 11:2's <br />Garden Grove Unified School District <br />Certification of Compliance <br />Payment of School Facility Fees <br />W1 <br />ftrICA q Z—1 <br />No. X(pproved <br />FOR PERMIT ISSUANCE <br />Master ID: <br />Telephone Number (� 14 q g n <br />Project Location soht Ol,� 011,b aver <br />Street Address City ZIP <br />wm Yle SGn-h� <br />Elem. School Int. School <br />High School V Thomas Map No. <br />Number of Square Feet c <br />of Residential Space �� X S. ^] Total $ [� <br />Number of Square Feet <br />of Commercial and <br />Industrial Space <br />Total $ <br />The above representations as to square footage are true. Developer/Applicant agrees that if it is <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 />Applicant is hereby noticed that any party filing a protest r ardin the imposition of fees <br />pursuant to Government Code Section 65995 and Education odeS clon 17620 must do so <br />within 90 }gays tom the payment of the fee. <br />5 z ItZ2 <br />Receipt of Payment <br />Developer/Applicant <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 received from 13�I hh ( 1 yvA()Y1Cj g -D�t 10) Rh h <br />11N Me h WAh(9A-+W&hJ five Qt4 4 �0/lvU Dollars $ (%s Wo <br />Cash Check ✓ Check No. 2 930 Bank lawn ll- T m&o(�L <br />q 1-1,5 M ore k KA*s xr-t ar <br />Date Superintendent Designee <br />Garden Grove Unified School District <br />(714) 663-6442 <br />9703.69` (Rev. 6/14) <br />