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�- - - <br /> J <br /> � ����� ������� ��N���� <br /> ,;, : <br /> ; <br /> �,. <br /> Permit No. �� 7�d� <br /> Date Permitted //- / <br /> B ilder Name/Owner Name � �/�, G�i� Control # <br /> � , <br /> C� unty Parcel Na �S Z(�- Z/-�z 1�� D�bd7�- �a ID SubDiv: l�{����1G�� F�V� <br /> A�dress/Location c� � � I�1- , �f c��r7'� R,p•�e �� � (o , <br /> Classification/Type of Use ��tA�I�1�d7Yt� <br /> TFtANSPORTATION IMPACT FEE Rate: Sq Ft Unit: �� � 7 � <br /> E empt [] Yes � No How Determined <br /> � I pact Fee Amount $ �1 ��C, -Zone No. T,qZ; <br /> S, HOOL IMPACT FEE <br /> A count (056) Single-Family Detached House Amount $ �� <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> E empt Yes [] No How Determined <br /> , <br /> P RKS AND RECREATION FEE <br /> L nd Account Land Credit Land Total <br /> ecreation Account Recreation Credit Recreation Total <br /> Z ne TOTAL AMOUNT $ � (Q�. � � <br /> xempt � Yes � No How Determined � <br /> IBRARY FEE <br /> L nd Account Land Credit Land Total <br /> acility Account Facility Credit Facility Total <br /> xempt � Yes � No How Determined Total Amount <br /> �ESOURCE FEE ERU <br /> TOTAL AMOUNT �� <br /> f <br /> �repared By � Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSP�CTION <br /> PERFORMED UNTIE.THE 70TAL AMOUNTS LISTED HAVE <br /> , � BEEN PAID AND <br /> RECEIPI'ED FOR �Y A CENTRAL PERIIflITTING OFFICE OF PA�CO COUNTY <br /> cknowledgement below does not Imply acceptance of concurrence,but slmply recelpt of a copy of this form,placing <br /> � the building permit owner on notice of this assessment and thQ conditions of payment for same. <br /> � i� �� / � _ � . <br /> � <br /> ATE REC VED BY <br /> ECEIPT NO. DATE � BY <br /> � � <br />