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� •�e <br /> ; ��t4.��� !�►���"���g �t�����.dl� . <br />� `� ' <br /> " � Permit No. �lD <br /> F <br /> Date Permitte�d��� <br /> , Bu Ider Name/Owner Name �r� ����� Control# <br /> � /� `�� <br /> Go nty Parcel No. � �- Z�-- �.-J..� Zl�3--L?dC�.Y?'L���4 SubDiv: �als'1 C.!'T ,�' <br /> Ad resslLocation ,'�7 ��� �G2�i'i�.. /L��- �.� � ��� �" <br /> CI ssificatiantType of Use �� ����- <br /> T �AN�PORTATI4N lMPACT FEE Rate: Sq Ft Unit: 1; j�i L_..� <br /> � Ex mpt ❑ Yes ❑ No How Determined <br /> IIm act Fse Amount $ .�i ���• Zone No. TAZ: <br /> St�HOOL INlPAGT FEE <br /> Account (056) Single-Family Detached House Rmount $ � <br /> I (057} Mot�iie Nome <br /> ' (058} Other Residential <br /> 123} CoNection Fee <br /> E empt � Yes [] No How Determined <br /> I P RKS AND RECREATION FEE <br /> La�nd Account Land Credit Land Tata( <br /> R creation Accaunt Recreatian Credit Recreation Tota! <br /> Z ne TOTAl.AMt�UNT $ ��, ��o <br /> E empt [] Yes ❑ No How Determined <br /> LI RARY FEE <br /> L nd Account land Credit Land Totaf <br /> � F cility Acca�ant Facifity Credit Facillty Tota! <br /> � <br /> �I E empt ❑ Yes (� Na How Determined Tatai Amaunt ����"'� <br /> � <br /> ', R�SOURCEEEE ERU <br /> '� T4TAL AMqUNT <br /> I <br /> P epared By ` Checked By <br /> Af0 CERTIFtC�4TC OF OCCUPANCY lMILL BE ISSUED C1R FINAL 1NSPIECTIt3N <br /> PERFORM�D UNTIE.THE TOTAL 1�MOUMTS LIS7ED HA!!E <br /> BEEN PAiD AMb <br /> RECEIPTED FUR BY Pd ClE1�TRAL PEIRMITTiNG OFFICE OF PASCO COUNTY <br /> A knowiedgemant befow daes nat impiy acceptance�of concurrence,but slmpty recelpt af a copy o#this form,pfactng <br /> the building perm(t owner on notice of thls assessment and thq canditions of payment fo�same. <br /> ATE RECEIVED BY <br /> ECEiPT NU. DATE BY <br />