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'•, <br /> '71 <br /> : � = P'�►�C� �tJU�VTYy �LC�f�IDA <br /> :� <br /> '� �� Permit No. ��� <br /> Date Permitted ��-�- <br /> Builder NamelOwner Name -` !(If.��It� ��',� Control# <br /> . <br /> County Parcel No. ��{-L�-Z1_ d��-���d'j}(,��(} SubDiv: �1 V�'r� � <br /> � Address/Locatian ��p ( d?- G't�t 1�f 7��'" � � �� <br /> t . <br /> GlassificatianiType of Use ��f1 1 /r�� <br /> TRANSPORTaTlON IMPACT FEE Rate: Sq F# Unit: ��"T�C,� <br /> Exempt [� Yes ❑ No How Determined <br /> � lmpact Fee Amount $ ���2� �one No, TAZ: <br /> SCHOOLIMPAGTFEE <br /> Account (056? Single-Family Detached House Amount $ �� ��. � <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [] Yes [� No How Determined <br /> PARKS AND RECREATIdN FEE <br /> Land Accaunt Land Credit Land Tota! <br /> '� <br /> Recreation Account Recreation Credit Recreatian Total <br /> Zone TOTAL AMOUNT $ 7 �� �,� <br /> Exempt � Yes � No How Determined <br /> l.IBRARY FEE <br /> �.and Account Land Credit Land Total <br /> � Facikity Account Faciiity Credi# Facility Total <br /> Exempt [] Yes ❑ Na How Determined Tota1 Amount ����--� <br /> RESt�URCE EEE EF2U <br /> TOTAL AMt7UNT <br /> Prepared By o ��� ,.�. Checked By <br /> -C�� <br /> NO GERTlFICATE OF OCCUPANCY'�11fIL.L �� I�SUED OR FINA'L lNSPECTION <br /> �' PERFORMED UNTIL THE 7QTAL AMC?UNTS LlSTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO GOIJNTY <br /> Acknowiedgement beiow does not impfy acceptance of concurrence,but slmply recelpt of a capy of this form,placing <br /> the bullding parmlt awner on notice af this assessmen#and fhe.conditions of payment far same. <br /> DATE RECEIUED BY <br /> RECEIPT NO. DATE BY <br />