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° � �: PA�CO CQUNTY, �L�RI�A <br /> � ,. <br /> I .. Permit No. 1��77 ' <br />� � � �j �"� �,� Date Permitted �(-�6 , <br />` � <br /> Buiider NamelOwner Name Control# <br /> Counfy Parce4 No. a5�2�5-2�-t7��a-t?Od(}—t�(}�C? SubDiv: -'��TL`PJh�n�r�S <br /> Address/l.ocation 7(p C�d �14 l( p�� �.) 7g�"_�„ �j.S `t"L 3 3S�Z <br />�i Classification/Type of Use Comwner•�C�e.� �r1l������C2 cs"��.,, <br /> TRANSPt3RTATiORt 1MPACT FEE Rate: Sq Ft Unit: � � _ <br /> Exernpt � Yes, � Na How C}etermined <br /> Impact Fee Amaunt $ �9r 3��• 7� Zone No. T;qZ: <br /> SCHOOL IMPACT FE� <br /> Account . (056) Single-Family Detached Hause Amount $ _ �- <br /> (057} Mobile Hame <br /> (058) Other Residential � <br /> 123) Coilecfian Fee <br /> Exempt Yes � No How petermfned <br /> PARKS AMD RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreatian Credit Recreation Total <br /> �an� T4TAF.AMOUNT $ c�. <br /> , Exempt � Yes � No How Determined <br /> LIBRARY FEE ' <br /> �.and Account Land Credit �and Ta#a! ; <br /> Facility Account Facillty Credit Facility Tota! <br /> Exempt � Yes [] No How Determined Total Amount�_�?�� <br /> i <br /> FtESdURCE FEE ERU <br /> Td7ALAMOUNT <br /> Prepared By �r��C��� Checked By , <br /> � , <br /> NO GERTIFICATE OF C?GCUPANCY WILL 8E ISSUED OR FENA�.INSPECTION <br /> PERFORMED Uh1Tik.THE 70TAL AMOUtdTS LISTED NAVE � <br /> BEEN PAID AND � <br /> REGElPTED FOR SY A CENTRAL PERMITfING C?�FICE OF PA3C0 GOUN't'Y <br /> Acknawledgement below does naf imply acceptance ot cancutrence,but simpiy receipt of a copy of fhis fosm,placing 3 <br /> the buliding permit owner on notica of this assessmsnt and thq conditians of payment for same. ! <br /> DATE REGEIVED SY <br /> RECEIPT NO. DAl'E By I <br /> � . . .. <br />