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Home My WebLink About23-5676IAA !tr: Lill � o '11i ~r r Nr � !ail I � 0! Ire 0 2 3 Mf s �► �Issue Date: 0 20, 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 I Building Department Date Received Phone Contact for Permitting 1( 908 770 -_ 7763 I I Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Owner Ph... Number813574.5700 Owner's Address 23975 Park Sorrento, Ste. 220, Calabasas, CA 91302 Owner Phone Number Fee Simple Titleholder Name I N/A Owner Phone Number Fee Simple Titleholder Address I N/A JOB ADDRESS 6988 Ripple Pond Loop LOT # SUBDIVISION Abbott Square PARCEL ID#1 04-26-21-0140-00100-0530 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR F__1 ADD/ALT SIGN DEMOLISH INSTALL F__] REPAIR PROPOSED USE SFR COMM OTHER F_ TYPE OF CONSTRUCTION BLOCK FRAME STEEL DESCRIPTION OF WORK Multi -family Screen Enclosure / Fence BUILDING SIZE U/R SF 2131 SO FOOTAGE1787 HEIGHT 28 1 BUILDING $ 255720 VALUATION OF TOTAL CONSTRUCTION 1 3_37 'q") ELECTRICAL 1$ 38358 AMP SERVICE PROGRESSENERGY W.R.E.C. F-71 [I(jIS PLUMBING $ 25572 MECHANICAL VALUATION OF MECHANICAL INSTALLATION t)l (D 0 17900.4 nq = GAS ROOFING SPECIALTY = OTHER L FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA IiF I YES 0 D BUILDER COMPANY 1 11-1111111 Tomes, LLC SIGNATURE REGISTERED Y/ N FEE CURREN LIL N_J Address 4301 NV Boy ScOut Blvd Suite 600 Tampa, FL 33607 License # =-CIC 15 18166 ELECTRICIAN COMPANY lEdmonson Electric, Inc. SIGNATURE A/ i REGISTERED I Y/ N FEE CURREN I Y/N Address License # I EC1 3005408 PLUMBER COMPANY BayonetPlumbing, Heating & AC, Inc SIGNATURE REGISTERED Y/ N FEE CURREN L11 N J Address I License# =CFCO4 MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc SIGNATURE REGISTERED L_IL NJ FEE CURREN I _7 / _N Address License # [CAC058062 OTHER COMPANY C SterlingQuality Roofing, Inc SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N Address License # I CCCO57991 RESIDENTIAL Attach (2) Plot Plans: (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 clumpster; Site Work Permit for subdivisions/large projects COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page, (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction. IIIIIII 1111111111 11 !!1 11 111111111111 11111 "1 111 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500) Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroof's if shingles Sewers Service Upgrades A/C Fences (PloUSurvey/Footage) Driveways -Not over Counter if on public roadways -needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division —Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law —Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection -Cypress Bayheads, Welland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers -Seawalls, Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit -Wells, Wastewater Treatment, Septic Tanks. US Environmental Protection Agency -Asbestos abatement. Federal Aviation Authority -Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone W" unless expressly permitted. If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a .,compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required, If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. OWNER ORAGENT Subscribed and sworn fo- (or affirmed) before me this 11512023 by Christopher Smith Who is/are personally known to me or#asA4ave_prodwce4 as identification. Notary Public Commission No. GG 296057 J OP211 Subscribed and sworn to (or affirmed) before me this �..21 by Christopher Smith Who is/are personally known to me or has/have produced as identification. Notary Public Commission No. GG 296057 Stephanie Farmer Stephanie Farmer Name Name of MV%WEFARW SMPHAK FARM E*m Fdmay 15, 2023 E*WFel*W1k202$ 0WW TliftImy I* Vmwo OWW7419 DESCRIPTION: LOTS 53-56, BLOCK 1, ABBOTT SQUARE PHASE IA, SITE PLAN SEC. 4, TWP. 26 S, RING 21 E. ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 89, PASCO COUNTY, FLORIDA PAGES 28-35, OF THE PUBLIC RECORDS OF PASCO COUNTY, (NOT A SURVEY) )ABBOTT SQUARE) PROPOSED ELEVATIONS AND GRADING ALL ELEVATIONS REFERENCED his SITE PLAN Prepared for and Certified To: SHOWN HEREON ARE TAKEN FORM THE O NORTH AMERICAN Lennar Homes ENGINEERING PLANS OF j VERTICAL DATUM OF 1988 "ABBOTT SQUARE RESIDENTIAL". PREPARED (NAVD 88) BY "WRA" PROVIDED BY CLIENT CURVE DATA (P) CURVE RADIUS ARC LENGTH CHORD LENGTH'. CHORD BEARING I DELTA ANGLE, LOT = 12724 SO. FT LIVING AREA = 2866 SO, FT_ ENTRY = 220 SQ. FT. GARAGE = 1058 SO, FT. COVERED LANAI = 374 O. FT. PATIO = NA SO. FT. POOL AREA NA SO, FT. CONIC. DRIVE = 504 SQ. FT A/C & CONICPAD = 36 SO, FT. SIDEWALK = 316 SO. FT. SIDE YARD SWALE = NA SO. FT. CONSERVATION AREA = NA SO. FT. LOTOCCUPIED = 42 Pia AREA TO IRRIGATE = 58 % C 16 C 16 100.00' 2093.2089. 5 17°06'35" W 1 1 °59'ZZ" \cR NPNCC I 'ss #PCC �SQA G0 CS- R� SbO�O yC\ N ��N a� � e\ 1b \ \ 5 eN 3by \ L V pl � \ � 30 5 P\bbb V m � O w. e 2l N 84'5204" W P -�--�.�f_j 34.71' P b1 ? �pJ 3 I n LOT 52 Vag v BLOCK I eV° c IT F�a1 a N 23 W �. /s - 17.9' S ar OF / Gi �/99 � b?fkF.ISS V,'Qz iP 67 9 "\ vv G /'O/ � Na0 v •. � „r LOT 57 (97.86) - NOTES= BLOCK 1 \ \v� y <'y9 ,• \\\ C,N .° LOT GRADING TYPE = B PROPOSED PAD ELEVATION- 100.00 FRONT SET BACK= 20' SIDE SET BACK =790p P v SIDE SETBACK (CORNER LOT) =15' OF '_ REAR SE BAa< 15 / (97.tB)- lQyG�P\GAT A. PROPOSED: MINIMUM FLOOR ELEVATIONS: LIVING AREA: 100.67' 1 // GARAGE AREA; �/ / x = 10.00' PUBLIC UTILITY EASEMENT ELEVATIONS REFERENCED TO / NORTH AMERICAN VERTICAL Noce ENTRY WALKSARE 7 3 LEGEND: i EGEISID: DATUM OF 1988 C/S-A/C UNITS ITs ARE 2.x2.7' / .,.�i--PRQPosED DRAINAGE FLOW APPARENT FLOOD HAZARD ZONE: 'X` COMMUNITY NO. 120235 (ERT00) = PROPOSED GRADE SURVEY ABBREVATIONS (MAP NUMBER 12101C-0289-F) EFFECTIVE DATE:09/26/2014 E-00.00= EXISTING GRADE AI -ARC LENGTH OF - DEED INV--INVERT PC - POINT OF CURVE IRE - RECORD LEGEND A/C � AIR CONDITIONER DE- DRAINAGE EASEMENT LB -LICENSED BUISN E PCC- POINT OF COMPOUND CURVE RNG=RANGE VINYL FENCE AF-AULKKN)MFENCF, EL OR E'•SV ELEVATION LE - LANDSCP EASEMt N` PCP - PERMANENT CONTROL POINT IRS -FAIL ROAD SPIKE 'CON( 6—U--.-.— BFE=BASE FLOODEt EVATiON ECI-EDG (11 PAVEMENT LFE-LOWEST FLOOLSEL VA ION °/E POO,. EQUIPMENT Ose - RI H OF WAY BM BENCH NWRK .SM'T-EASEMENT PC, LICENSED SURVEYOR " PA SEC - SECTION WOOD FENCE C-CURV'-ASPHALT \ 1 IC1-CA.CUA tD •/C FENCE FORGER IMF =MEASURED Pi, ON O. INt'ERSFCt10N SN&D S NA..ANDI?:SK CENT 2INL NF CM -FOUND CONCRETE MES -MTERF INDSECT'ON PK-PARCERK9O,N _318183 CLAN LNK FENCE ` "CHANT ENCE Sv 0NUMEN NC` - NO CORNER FOUND z ROPRTY LINE SR=SE 12'IRON ROD IB 8t83 _-FOUND RPN[II'E C/A-OVEPA.. POB PON' OF'3EGNN:NG TBM==MORARY BE NCH MARK = ICIC —�[-- — CMP=CO.RUC,A CD META-_PIPER_FOUND IRON ROD OHW-OVERiLEADKaA`GI POC PONT OF COMMENCI MENT TP9=TOP OF BANK COL=COLUMN =N&O=FOUND NAIL h DSK O.R-OFFICIALRE`CORDS POL PODO ON LINE TWP=TOWNSHIP° ALLIMtNUMFENCE CONCT CONCRFTF =OP=FOUND OPEN PIKE (P) -PLAT PRC ^• PONT OF REVERSF CURVE UP— UTILITY EASE MENT 12< ^COVERED C/S=CONCREIISCAR cpp FOUNOPNCHEDTIE PB-PLAT BOOK PRM-PERMANENT REFERENCE MONUMENT VF=VINYL FENCE \\ CST= CLEAR S GH r TRIANGLE JOB #6173 SURVEYOR'S NOTES; SURVEYOR'S CERTIFICATE 1708 Water Oak Drive 1.) Current title information on the subject property had not been ) i This certifies Au �ii'UI hereon described Tarpon Springs, Florida Date of Srte Plan I 1-23-22 furnished to Initial Point land Surveying, LLC at the time of this u property �R12 �e SI etvision and Phone: (727)-831-1990 TWG:AS-L54 56 ft' SITE SITE PLAN meets `$ rachce for FlondaPLS 7123C@ mai).com 2.) This sketch was prepared without the benefit of a title search. curve 'J'as � r )�);{ -�a BF0rd of Land LB# 8183 9 a' No instruments of record reflecting ownership, easements or y�ry - �1.7 11t �C18C) qle, rights -of -way were furnished to the undersigned, unless otherwise dl FI Ad n .First Ive d p shown hereon. -"7Pu o e It n 47i.,� c $ artle Drawn by . 3.) Roads, walks, and other similar items shown hereon were take StatCes'+ Checked by _IH from engineering plans and are subject to survey. s Ddt2:' Y^�.S.O � .d 4.) This SITE PLAN does not reflect nor tletermine ownership. € v1, t { gg �% C a� � REVISIONSID�2Qj'QQ' kt 2 . A} i k BO ens SQUARETT PHASE IA matters shown on the Plat of _---ee S� �' O _---- 5.) This SITE PLAN is sub wn Jeff M. H (,[kite hereon are in feet and decimal portions FLORIDA P MAW YOR AND Q thereof. MAPPER #711iSIL183 7.) Contractor and owner are to verify all setbacks, building dimensionsand layout shown hereon prior to any construction, NOT VALID WITHOUT THE ORIGINAL and immediately advise Initial Point Land Surveying, LLC, of any SIGNATURE AND SEAL OF A FLORIDA "f deviation from information shown hereon. Failure to do so will be LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC. It users sole risk. v T U A L R E V Vv A S Notice to Building Official of Use of Private Provider Effective January 20, 2003 Project Name: 04-26-21-0140-00100-0530 Parcel Tax ID: Services to be provided: Plans Review X Inspections Note: If the notice applies to either private plan review or private inspection services the Building Official may require, at his or her discretion, the private provider be used for both services pursuant to Section 553.791(2) Florida Statute. I the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: Private Provider: Address: VIRTUAL REVIEW ASSIST, INC. Telephone: 813-376-3088 Fax: N/A Email Address (Optional): deb@virtualreviewassist.com Florida License, Registration or Certificate #: (LIC # BU1967/ PX2300/ BN4615) I have elected to use one or more private providers to provide building code plans review and/or inspection services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida Statutes. I understand that the local building official may not review the plans submitted or perform the required building inspections to determine compliance with the applicable codes, except to the extent specified in said law. Instead, plans review and/or required building inspections will be performed by licensed or certified personnel identified in the application. The law requires minimum insurance requirements for such personnel, but I understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmless the local government, the local building official, and their building code enforcement personnel from any and all claims arising from my use of these licensed or certified personnel to perform building code inspection services with respect to the building that is the subject of the enclosed permit application. I understand the Building Official retains authority to review plans, make required inspections, and enforce the applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I make any changes to the listed private providers or the services to be provided by those private providers, I shall, within I business day after any change, update this notice to reflect such changes. The building plans review and/or inspection services provided by the private provider is limited to building code compliance and does not include review for fire rode, land use; environmental or other codes. The following attachments. are provided as required: 1. Qualification statements ' and/or resumes of the private provider and all duly authorized representatives. 2.. Proof of insurance for professional and comprehensive liability in,the.alnount of $1 million per occurrence relating to all servieespeifbime-d. as a private -provider, including tail coverage for a minimum of 5 years subsequent to the performance of building code inspection services. Individual Corporation Partnership I . Print Name: Address; Telephone KT_ I Please use appropriate notaryb1bek. STATE OF FLORIDA 1110""Mmedgm; r�� B D.fore, me, this day of 20— personally apijeaiDd - who executed the foregoing instrument, and acknowledged before m5 that same was cXe,riite-d for the purposes therein expressed. Print CorporationName By: (signature) print Name. Christopher Smith Its: Authorized Aa ent Address: 700 NW I OZtb-Ave Miami, FL 33172 Telephone. No. 913-574-5700 Print Partnership Name By:, (signature) Print Name: Its; Address, Telephone No.: Partnership Beforeme, thus -day of 20_ personally appeared p artner/agimt on behalf of a partnership, who executed the foregoing instrument and acknowledged before me that same was emeoutedfor the purposes therein expressed. Personally known X ;or- Produced idmtif cation Type of identification produced Signature of Not NPrint Name A ASHLEE CALLAH N Corporation Btfbre, me, this 22ND day of MAY, 20 2_2 personally appeared, Of Lennar Homes, LLG. a Corporation, on behalf of the state corporation, who executed the f6regoing instrument and aclokwledged before MD that same was executed for the purposes therein expressed. Notalypublic Stamp: ". ComrfdssionExpire�s: 4% ASHLEE CALLAHAN MY COMMISSION # HN 295980 EXPIRES: t4overnber 30, 2026 Page 2 of 2 VIRTUAL REVIEW ASSIST Private Provider Plan Compliance Affidavit Private Provider Firm: Virtual Review Assist, Inc. Private Provider: Debra Anne Klahr, BU 1967 Address: 747 Southwest 2nd Avenue Gainesville, FL 32601 Phone: 813-391-2959 Email: Lacygvir—tualreviewassist-com Project: New SFT Address(s): 6988,6992,6996,6998 Ripple Pond Loop tt e w for an are in I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed r d e compliance with the Florida Building Code and all local amendments to the Florida Building Code by the following affiant, who is duly authorized to perform plans review pursuant to Section 553.791, Florida Statute and holds the appropriate license or certificate: Name: Debra Anne Klahr Plan Sheets 1,2,3,4,5,6,7,8,9,9.1,9.2,10,11,12,13,14,15,14.1,16, L- 1,L-2, D 1,D2,SN,SN- 1, S3M,S4M,S5,S6,ST,SS,WP,PAI-0,PAI .1, PAI.2,PAI.3,PAI.4, SHI.0,SH1.1,SH1.2,SHI.3,SHI.4,SHI.5 Florida License/Registration/Certification 4(s) and description: FS468 Certified Standard Plans Examiner License 4: PX2300 Signature of Reviewer: -T- SWORN AND SUBSCRIBED tqfore me by Debra Anne Klahr being personally known to nv—o'or having produced as identification and who being fully sworn and cautioned, state that the 4 fo eg ing is true co ect to the best of his/her knowledge or belief. Notary �JtNarn�e�� Siature�—off Notary Notary Public: NOTARY STAMP BELOW My ❑ COMMERCIAL BUILDING SERVICES DIVISION IV RESIDENTIAL BUILDING PERMIT DATA SHEET Rennired Permits Building ❑ Inspection Onl Plumbing ❑ Ins mction Only IV Mechanical ❑ bas ection Onl Electrical Amp ❑Ins ection Only_ tZ Roof ❑ Gas El Medical Gas ❑ Fire Sprinklers ❑ On Site Piping ❑ Fire Line ❑ Irrigation ❑ Fire Alarm ❑ Potable Backflow Assembly ❑ Fire Line Backflow Preventer ❑ Irrigation Backflow Assembly ❑ Demolition ❑ Walk-in Cooler ❑ Refrigeration ❑ hood ❑ Ansul ❑ FencelWall ❑ Grease Trap ❑ Other ❑ Other T e Construction:-� Risk Category: Occupancy Load Occupancy Classification: ❑Factory ;Residential ❑ Assembly ❑ Hazardous ;❑;Storage ❑„Business f,]-Day Care/Educational ❑Institutional ❑Mercantile ;❑ Utility Building Use: Sincale Family townhouse / Alteration ❑;Level I `❑';Level 2 Level 3 VNew Construction ❑ Interior Finish ❑ Interior Remodel ❑ Exterior Remodel ❑ Addition ❑ Revision Overall Size: 20 x 58 Number- of Stories: 2 Total Sq. FL: 2131 Living Area: 1787 Covered Area: 344 # of Bedrooms: 3 # of Baths: 2.5 Cost per square foot: Estimated Value: 17 Roof Type: ® Shin le ❑Tile ❑ Built-up ❑ Metal ❑ Other Squares: Zoning: Windborne Debris: '❑=Inside Outside Energy Code: 405-2020 Flood Zone: X Base Flood Elevation: Finish Floor Elevation: Hydrostatic Vents ❑ Ves No Sq. Ft. Enclosed Space Below BFE: # of Vents: Size of Vents: Total Sq. In. Permanent Openings X❑ Central A/C ❑ Gas A/C Heat Pump ❑ Gas Heat ❑ Window A/C ❑ Electric Heat nn Citr pining Sanitary Sewer Storm Sewer Catch Basins Potable Water Under round Fire Line Front Rear Left Right ❑ Asper Approved Site Plan Comments: Builder Name/Owner Name County Parcel No. SubDiv. Address/Location �Z9 TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit: zLL_ Exempt E]yes 0 No How Determined Impact Fee Amount S t Zone No, TAZ: SCHOOL IMPACT FEE Account (056) Single -Family Detached House Amount (057) Mobile Home (058) Other Residential (123) Collection Fee Exempt = Yes = No How Determined - Land Account Land Credit Land Total Recreation Account _ Recreation Credit Recreation Total Zone Total Amount Exempt =yes = No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account _ Facility Credit _ Facility Total Exempt = Yes = No How Determined -Total Amount RESOURCE FEE ERU 9F1 OW V14irl WnT I RM M