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HomeMy WebLinkAbout20-1142 m � ICU City of Zephyrhills PERMIT NUMBER 5335 Eighth Street _ Zephyrhills, FL 33542 DBILEHOME-001142-20 Phone: (813)780-0020 Issue Date: 02/10/2021 Fax: (813) 780-0021 Permit Type: Mobile Home Property Number' Street Address 34 25 21 0090 00000 0010 37756 Neukom Ave Owner Information Permit Information Contractor Information Name: JOSETTE CARIERA Permit Type:Mobile Home Contractor: GTS MOBILE MODULAR Class of Work:Mobile Home New SERVICE INC Address: 6110 Champions Gate Blvd Building Valuation:$26,000.00 ZEPHYRHILLS,FL 33541 Electrical Valuation: Phone: (813)480-6137 Mechanical Valuation: Plumbing Valuation: Total Valuation:$26,000.00 ^ I Total Fees:$7,876.50 Amount Paid:$7,876.50 Date Paid:2/9/2021 1:22:14PM Project Description INSTALLATION NEW MOBILE HOME SET UP 1,341 SQ FT ;1 Application Fees Mobile Home/Park ModeVRV Setup Fee $65.00 Public Safety Impact Fee-Admin $26.35 Park Impact Fee-Mobile Home $573.73 Transportation Impact Fee-Mobile Home Park $3,595.68 Mobile Home Water Connection Fee $505.00 Transportation Impact Fee-City $36.32 3/4 Water Meter Fee(Calc) $732.71 Mobile Home Sewer Connection Fee $1,045.00 Irrigation Connect Fee $175.00 Mobile Home-Plumbing Fee $45.00 Irrigation 3/4 Meter(Calc) $732.71 Mobile Home-Mechanical Fee $45.00 Public Safety Impact Fee-Police $254.00 Mobile Home-Electrical Fee $45.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE PE 7MIT OFFICE �ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER i t r I k aty7eo-a�7o Gly of 2aphyth;lls Permit Application F.tt3.7aDaax: auwtTng oap"—% i r 'IIt7rICE OF O[Etl RESTRICTIONS The unerrstgted arrldciatanas Ilnt Un?Pnm1 may m sut{ia to"deed'Ics4i=ura'> may be mgr;e rca!dCve R.tiri Couny,rcgidetipns�Tl;e dnCe.:s�yiM aseume&rixConsdiryfaL'nmpisr(Ce_sNh arty epdulie EcAd leaii(:.iors ' UNUCENGED'CONMACToNS ANa CONTAACLOA HF9PON561t.ITES:tl the ovna Mf tJreE a ctii+aWlr w conUeCae to u'�Qirlakc,waL,tlay l .may Ue rquled to 0'e icesaed rn aci:ordsnce W;h state anE bcd redutsdons,adee m�:raaera nat7cenECd,aireedbytaw:talk die'pnew art! ccol+crprmaY'bdoled fdre miseemeariv Udatlan Lvkasla:eCK.dthe ovwt,c'mtrdee cw;7�'o,aeilncenartas to wlw7,Icersit,ie,u+oneMe mayapvly_lot the Inicrdm v.�sk,t�%era ed,4rd fo contBC ida Pasco Co:sdY BuAd"ng Unpeddan D:tsion.J.ix sa:g St=dan at?2)-Fd7_Eaa?). i FUWd mcvo;It We am;&has Nrcd a m*tia a u rrxtl etle s.to is awire d to'hsw I:m,w-4,"lorifl sin pa4ars d,Uw'rb:kac'tm.aloct'd iHs sppFmtiM'fir voJei diey:vr30e rrrno!t tie,It yaiL astho ca.-..er syn Be o'viUadif,!ha:mrr W antnti�emyl:ra fti Y rI A Ixoyeny 6orsiri4 mU c y cot eUh¢ed'Io Pc-mt!Unq Vrdr�ei Pasco Ca,My. TRANSPORTATION,IMPACTIUMUYIES IMPACT AND'RESOURCE RECOVERY FEES Ille undersignetl utideishnds fhel l}a'apa'.al,pn Ynped Few and Acmarse Rry eryFer.mayappyb e.e mristniniai e:rn+,tiabngEt 4arye;o!use in irisbi•.p b:dd rr,cr oiprnshn d esisi(rtg burlatgc,as&vcvf tdtn Pasep carry 6'4oiance.mmbor RIDT.vie PD-07,as wnended,77>e Undersyriotl also unddstarm,11W cochleas,as maybe %A!b:iecn%ed'at the l'mi of,pertrillirg,Jib r¢rdite urderstoodtt&Tre&"1AEen I^patt Fees oral Rceourc¢P.ecavgy Feaairnrsl fie paidnmr.to recrrr:nge'eadfrate nrocoapaniq:'ddtiol pater,reuse.t!UeplvedEoes'rglryJa4cas'tstdxalc of ocwuahcYafnsl : bpae*.r_'ease:[nefem:.vsl be Md ermr,lo peraii"rtsuencer,Eunheinae,ePaces Covrdy We;ert5iwatlinCacl fc'esarc dace;tlrey rtWi!to paid rytar r b prrteilCswance n acmroarra ws(n epsiirade Paso county&drionets. CONSTRUCTION LIFN L'AW lChiptei 7i 3,.FlPl�di 62itiriea;'ts'ardetMedl It rlua4m d�+at�s 5?,SOIt,DD ormora l misty Ih81I,.lne appfwr.L 'raw lies:P-vded s,ittie ropy Er the-fwnae l:oii&Wciton Lin Ua v-4cit ,;Prti:eClan Dube p:lpd!ed Uf,t!<Flaw DeAartr:�rnl d Agne+tu+e and Cgryumv,Aeous'rp_rie Bppvw"t is E ivice—rd er!tan ttr'afflwi%I cwi Ital I hc+v atyeinrd a LYgy d the otmvc;desulced 4&w.4k an2ixuMi&e;n pwdm-th to deLNCS r'Jaiha'r m-Floc tii'wn_ninnwginnL P COf1TRACTOR'SlowtsEwa AFFmkwtT;'t ceifiy that A Bic ecrrniliDii'n,llt.B'ap{i5a 000n U"aceiiale rind dui a1.es1,vn91#lane h eG,mp9aree reUi " A appfcaola lives tcgWsing r.-wh6mcr,m N oa d Land dele4.p+cenl,ApPl[et4n h he thymade fu edfain a'oermllb do'Y.*andrara%Obn as. W"lef:l cd10ybut he YArk'a `dsuanw of a permit and d!ii ac WYt w1 tie peffo�dd Io ince.Eloidd'dp d a7 leas reguletra eailmaCiai Coiprry ard,Citif eodea;;on:ng reguWlvas,..a(epd 6—)Db,1-erg rogurabonc rn tsiu.pase,raa.I el c'WOY vta_t I •",unaCelmid trance r<gLejVwis d dhe`pivemmert aycneas m8y iPmyl6 nre Ifamded*ck and tl+et rt'ismyrespo!eptftylo Nrntrry veial.er3ore 1 m_iaitete b[s toctr+ptrticc.Surh egenries 4 Jude but era�rotfrnecd ro: Depaitment d Environmental.-Protection•Cypress Boytw_ads,Welland'Araas and EnOronmerlally Sensitive Lands;WaleriWaslewaler Treatment. S6utIiv.asI Florida Water Management District-Wens, Cypress Bayhgads, Wellird Areas, Aflefirg 'Watercourses. Army Corps of Engmears-SetiwaAs,Docks,Wa»gaold Wate'ways.. _ Departimerii of H_eaHh&Rehabilitative ServieeslEn»rrnmenlal Heats Untl-Wets, Waslev+aler Treatment. - Septfc-Tenks. US.Environmental Protecpon-Agency;Asbestps abatement. FeCeral'Ayialion Authority Runways: I urdeniand,Out the ldt*'tng lhe cWrtc9ont,ap7rr lo use of fr'. Use of fig Is nDI,jk ked in Flood Zone'V'unless expressly permitted. 11 die fin material Is to be'used IL Flood gene 'A'.it 7s.understood Thal,a drainage plan'addressing a 'campansabng volume,wid be subrryited at,time of pemilOIng-vA9ch is prepared by o professlwial engriiemr licensed Dy the Stole of,Florida, if the'fill maieria!is to be used fn Flood Zone W in:connection W31 e.pormilted'-iwlding using stem will obrisVitcbon,ll ceibiy that 60 w111 6e used only to rill the area vnbdn'the stem vrllt, i If.,fin material 1s to Be used in,any area;,I certify lbat.use or such,fill train-not adversely.affect.adjacent properlies,df use of hU!W fdund to adversety affect adjacent propodfes,the aHner may be clad for,viotabng Ihei cond,tions Of the build rm ing peil.tssued.uriaer dw attached pe!mlt apoIcidiiri,fof" lots less'than one(t) eua which are eievaled;by fikan envneered drainage plan is required, Plir'uro'AACNr FOR THE UyyNEfl Iprorim(saMgoaG:olh to&lentl'yte:riiaVX d the pdr*;Nnq ev'7rmc set Men!,Urs ai!4u iPrayw cvt a rig consuue9nn.Iunlrrstera!netasepa�ite Persil—ibe reS+ired tot r!eG+erd'wedi tyu'rnting',sig ,waR,pnrs,ci ttrgitio!irt'�,g,'g�tx c:ftir i!ecrdlatkns nal fnedA al Y,s)t k dec yt inoapp zm.A pwrrit SEVird st aA be comtnred to M-(omit(o piocee0,tirth l!o Wdk art no:as imty b'v uate,cancel,ercr,or 3e xaa'ap!p'aispra of Ua ltcnrcit codes,w'sal iswaree d a:*emit Va—1 ee Htxtling;0'aca Iroen oareara regi Ana a cdnecson d mro.a M r.+-mui"cmiV,r'.co v ario%d.arry'toaK.E,,E y Punt!isudw t arbederr.mwd wen xs Uro—k 'nanmaw.byL'Jeh perm.lic Ca'nRtfitlx ML'III SR menthol nr pe r,rl SEUanCE.V wCK 6r11F'�lid eY Uie Pei?M1.C{Gic ._red O 9SiR:dmed!af a ecru.;of W'CalmonRa GM1tr Vn tmcihf won a twrnrnerem:An enansron.may b rnq'urEieA,n tin;.g,,hm,lne eiritenc tttca[lor a[kn'YI rn1 tt. i euece nl^ary luP)Eeyc aw++ai eemenarate IusLSada,cayse tr do riten;tm:(f wet onset far dnaty,taD2'comcru¢ve daYi,¢:e'pois'mnsa3red "-'-WARNING-TO'OWNER:.YOuR-OAILURE TO' RESULT!IN YOUR PAYING'TWICE.FOR IMP,ROVEMENI`S TO YOUR PROPERTY;IF YOU IN O- _ -CINCE,CONSULT FLOtUDA "T tt .71 __. _ - — - OWNER A6E - - —COY(r,A,AC.Tow Sy a 1DM Suusmoua'enbs omen erUmi'ebL+'a's'ra+�;L + --r Vltb d'Jara pw¢anaiY krle'hnt Ae Kha .dpT.dUred YR"e l:'a aPe YYt.om'.Loma drlV`m-re'r_p'sd:Gatl r i,��__s.)GN�^ia':ry,•µ¢rasa ,� .� NWaly R,p.t.c ca.'sr 25%, cry o ste.E++.r°".c fuoar ' i.an �:"'r;� open aeaino:i F:a�r'eo'7,rorzn ryi�e¢.rrr�:umdo7---_-_— _ i i I INVOICE1111 FOR OF • P-- .A BILLIN TACT EGNERGTS MOBILE MODULAR SERVICE INC 3102 JOP TUCKER RD (' INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION INV-00002125 12/17/2020 12/17/2020 Due NONE REFERENCE NUMBER FEE NAME TOTAL MOBILEHOME-001142- 3/4 Water Meter Fee(Calc) $732.71 2020 Irrigation 3/4 Meter(Calc) $732.71 Irrigation Connect Fee $175.00 Mobile Home-Electrical Fee $45.00 Mobile Home-Mechanical Fee $45.00 Mobile Home-Plumbing Fee $45.00 Mobile Home Sewer Connection Fee $1,045.00 Mobile Home Water Connection Fee $505.00 Mobile Home/Park Model/RV Setup Fee $65.00 Park Impact Fee-Mobile Home $573.73 Public Safety Impact Fee-Admin $26.35 Public Safety Impact Fee-Police $254.00 Transportation Impact Fee-City $36.32 Transportation Impact Fee-Mobile Home Park $3,595.68 37756 Neukom Ave Zephyrhills, FL 33542 SUB TOTAL $7,876.50 REMITTANCE INFORMATION TOTAL $7,876.50 City of Zephyrhills 5335 8th Street Zephyrhills, FL 33542 December 17,2020 �� 5335 8th Street,Zephyrhills,FL 33542 Page 1 of 1 INSTR#2020219330 OR BK 10243 PG 2449 Page 1 of 1 12/22/2020 12:09 PM Rcpt:2241032 Rao: 10.00 DS:0.00 IT:0.00 Nikki Alvarez Sowles,Esq.,Pasoo County Clerk&Comptroller Permit No.: Tax Folio No.:342521009000000010 NOTICE OF COMMENCEMENT State of Fl. County of PASCO The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. 1. Description of property: HRAND HORIZONS-PHASE ONE PB 34 PGS 99.102 LOT 1 37756 NEUKOM AVE ZEPHYRHILLS FL 33540 (legal description of the property,and street address if available) 2. General description of improvement: MOBILE HOME SET UP ELEC HVAC. PLUMBING 3. Owner information or Lessee information if the Lessee contracted for the improvement: a. Name and Complete address: JOSEiTE CARIERA 37756 NEUKOM AVE ZEPHYRHILLS FL 33540 b. Interest in property: owNER c. Name and complete address of fee simple titleholder, (if different from Owner listed above): 4. Contractor Information/Person responsible for the improvement: a Contractor STS 3102 JAP TUCKER PLANT CITY FL 33596 1 (mate and complete address) b. Contractor's phone number: 6439973705 S. Surety(if applicable,a copy of the payment bond is attached): a. Name and complete address: b. Phone number: c. Amount of bond:$ 6. a. Lender: (name and complete address) b. Lender's phone number: 7. Persons within the State of Florida designated by Owner upon who notices or other documents may be served as provided by Section 713.13(1)(a)7,Florida Statutes: IL Name and complete address: b. Phone numbers of designated persons: 8. a In addition to himself or herself,Owner designates Of to receive a copy of the Lienoes Notice as provided in Section 713.13(1)(b),Florida Statutes. b. Phone number of person or entity designated by owner: 9. Expiration date of notice of commencement (the expiration date will be 1 year from the date of recording unless a different date is specified). WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING UR NOTICE OF CO ENCEME (Si are of Owner or Lessee,or Owner's or Lessee's Authorized Offraer/Drrector/Partper/Manager) (Signatory's Title/Office) The foregoing insnt was ac owledged before me this day of 20 by t)S ---.,(panic of peison)'as"' (type of authority e.&officer, trustee,attorney in fact)for (name of party on behalf of whom instrument was executed). t-Aau- MOMKI1111118y (Signature of Notary Public-State of Floriday NOWry Pub9c ; (Print,.Type,or Stamp Commissioned Name of Notary Public) z Stata of Mdda - COMMO NN02BM Personally Known OR Produced Identification ' B Ua O/2024 State Of Florida,County Of Pasco 4�> This is to certify that the foregoing is a �} true and correct copy of the document on file or of public record in this office. � tnesss han r nd official seal this �_day of t��C:,�' 1�2_@r� ' Nikki Alvarez-Sowles,Es Clerk& troller 1897 Pa ounty,Florida I Comptroller p e B D uty Clerk Ct�re tac�y Y I 81;�78D-00 City of Zephyrhilis Permit Application Fax-813a80-002t I BuiWing'De`pattment. Date Recelved, r _t ' Phono ContedtorPeiniittin i !"aa!!al[l e aa ttt�'l - Owner'e Nambu e - F ,� Owner Phone Number y utOwnees Addreca __ _. -_ ti 1 y :fI Q(ker Phone Number i i Fee Simple Titleholder Name Owner Phone Number ! Fee Simple TMaholder_Address, JOB ADDRESS SU LOTTI#�) r� SUBDmsioN V�. r Q1tZL41' PARCEL IDS' — -' -. U.V rf J(!o / Uad a (OETNNED FROM PROPERTY TAX NOTICE)' WORK PROPOSED rNEWCOMTR ADDiALT Q SIGN 0 Q DEMOLISH INSTALL 8 REPAIR PROPOSED'USE SFR 0 COMM 0 OTHER . - TYPE OF.CONSTRUCTfON 0 BLOCK' Q FRAME Q. STEEL DESCIi1PT10N.60 WORK .O . 1 C) r' i BUILDING SiZE SQ FOOTAGE L-j HEIGHT BUILDING S, V VALUATION OF TOTAL CONSTRUCTION LECTRICAL 5' AMP SERVICE Q PROGRESS_ENERGY_ Q W.R.E.C. 3 _ l _ PLUMBING $ - CHANICAL $ VALUATION OPMECHANICAL INSTALLATION QGAS' M ROOFING' „Q SPECIALTY Q; OTHER C i FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA z YES NO - BUILDER COMPANY -- SIGNATURE _ _ _ RearstEtiEo N _FEE cuRREN Y:I:N i - Address License fl ELECTRICIAN. COMPANY SIGNATURE -._._ _. . REGISTERED YIN FEE CURREN' WI N / 6 Address Licensed -- PLUMBER COMPANY SIGNATURE REGMTEReo I.IYAN _ FEE CURRErc Y-I N - Address LicenseBy fl _ MECHANICAL /� COMPANY V, SIGNATURE REGSTERED Y N FEE CURREN -_Y.i'N J G c Address License; _ OTHER COMPANY SIGNATURE REGISTERED I YIN FEECURREN Yd-N Address -- — Lfcensafl a'goolvalanIf'1244lila.!!llfla2462,/11a7!'s sale a_a-la/i:a/sill!!!!;•!!l alto tillrJ'f RESIDENTIAL, Attach(21 Not Plans;(2)sets of Building,Planw(1)'set of.Energy Forms;.R-0-W Permit fornew construction, Minimum ten(10)working days after submittal date.Required.onsite,Construction Plans,Storrnwater Plans w_l Silt Fence installed, Sanitary Facilities&1_dumpster,Site Work Permit for subdM§iansliarge projects COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Sefe_ty Page (1)set of Energy Forms.R-0�M Permit for new construction. Minlrrium ten(10)Working days after.submittei date.Requiied,onsite,Construction'Plans,',Stormwater'Plans wL Silt Fence installed, Sanitary Faei60es A 1 dumpster.Site Work Permit for a0 new projects.AN,Commercial,requirements must meetcornpliani e SIGN PERMIT Attach(2)sets of.Engineered Plans. i _"PROPERTY'SURVEY required for.all NEW construction, Oirectlons: Fill out application completely. Owner&,Contractor sign back.of application,notarized Ii over 62500,a Notice of,Commencement Is required.(NC upgrades over$7600) •' Agent(for the contractor)or Power of Attorney(for the owner)Would be someone with notarized latter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs 6 shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW i I *4 AL.L WORk..'SHAU ,WiTH,PkevAjL'iN6 IDA SUILDINd CODE, --NATIONALEL�di,-R IC CODE, -AND TH15 Cl TY-10F ZEPH RHILLS� y CES rEL ,k. - 5 Yr fe; pi z 1Z, IR 1�4 At Ja Li 1 1- Ut 7 MA :. r 4 1 +, t ,f t •`t �i •x r 1 i, r:f .. t 't• i „fnY y-• 4 H�w a� "E h •f. A Q'.'•. fi iwi Zr 1:1 h J =Y•k t �{ rt G xni(l:,a l t.f•. {} f 5 +-5l- 5 h' 1.. Stij•' .. a�• t i✓.t.. ,t t y� .i. a.x .Y� ?IN:tY i r - - �is_ .ftC`3 .y• "u f' .. f: frfi, • r k,' 51: t' 3 ,V•fx �. .w t-• �4q; ya 5.'3 J' 5' +F :f\ t '•{f= M I4 y, ' v J. f� 3 - S 5 'r sP.aVa - 4 z T� x. :.r a_ 3� •• .tl' r.! a� 3 5 Y' vaa:, s r�:•� t:. as R -Y F .t. r x / �5 :,ate f rx✓ 7• «r `'t 4 rye.y "a r i u •1 1K:+ 3t t. ts: 1t '•s =J •J _ •Y 1 :.I 4r `v ,f is \= 4v;• two `.: J t (/ .1 t xa� � _ f }^ ,-Yl:ti t� p �j ham: p a' Q -rx •s- Q ..a 4• t x•. pit.. 8:c: .t> ::�•:` °1:ewjd.• !tt b •M ni /h t'• •:i 1K• - i.r ,. �ii�•Y t•� <k.t: 1f3F:' i• .cq - _ rJ l: . 'tn xt•"`:5 .•C` 77 1.S ri , •Y .t �rkti. y' x , f [[ PASCO COUNTY, FLORIDA Permit No, -� �// f Date Permitted I�- �Builder Name/Owner Name U/f� l s NA`0 Control W County Parcel No. 34 2-5,Z l"6,0 9o. d l l "SubDiv: 67fz . Address/Location 0 /--,'7 ll s/ . ,Y Cfassiflcationlfype of Use ��+ !'e `$ TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: - -- Exempt ❑Yes ❑ No Hod►Determined Impact Fee Amount ".$. ` � Zone No. TAM: SCHOOL IMPACT FEE Account" (056) :SlrigliFamily Detached House Amount $" (057) Mobile-Home (058) Other Residential 23) Collection Fee Exempt d Yes []No How Determined I - PARKS,_AW RECREATION,FEE, LandAccount Land Credit Land Total Recreation Account Recreation"Credit Recreation Total Zone TOTAL AMOUNT $ 73>`7.v� Exempt ❑Yes [) No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Faci ity Total Exempt ❑Yes [] No How Determined Total Amount RES.OURCE'FEE- ERU TOTALAMOUNT Prepared By ' Checked By NO CERTIFICATE�p1=OCCUPANCY WII L,BE:IS3.UEpOR=FIIdAL:INSP"ECTION PER'N=©RMED:Cli�tTlE>Ttl��'A7'AI.1tMO1JN1'S.LiBTED:Hi4VE B.OMPAIMANCl: RECEIPTED:FOR.BY.A CENTRi4�I:-$ERMITTtN0 OPFiCE.OF PASCO COUNTY Acknowfedgement,balow.doss not imply acceptapce;of.concurrence,but stmpiy'feoelpt of•a copy of"ihie.form;Placlno ft buliding pemiffown®r•'o4'notice of tliis"asseseiment and tha-condlticns of payment forsama.' DATE RECEIVED"BY RECEIPT NO. DATE BY