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: �AS�� G�1l1NTY, FLC�9�i�� <br /> ' ' .. . Permit Nq. �g 65! <br /> Date Permitted �� <br /> Buiider Name/Owner Name �� ►'7�Yt (�+G Controi# <br /> Gounty Parcel No. (��{-Zby2/—bb7o�-oblba-j�!`�'a S�bDiv: �'��if��R�O <br /> AddresslLocafion ��P t� U�-'�r'a 7'111� [}i� <br /> Classi�ca#ionlType of Use 7�l � �(� �- <br /> TRANSPCiRTAT10R1 IMPAGT FEE Rate: 8q Ft UnEt:,��,�— <br /> Exempt �Yes [] Na Now Defermined <br /> (mpact Fee Amount $ ��3�-� Zone No. TAZ: <br /> SCHOOL IMPACT FEE il <br /> Account (056) Singfe-Famify Datached House Amount $ _ `7��7�v� �-�O <br /> (057� Mobile Home <br /> (058) Ofher Residentiai <br /> - 123} Callectian Fee <br /> Exempt � Yes [] No How Detarmined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Gredit Land Totai <br /> Recreation Account Racreakion Gredit Recreation Totai <br /> Zone T.OTRL AMUUNT $ 7�T g„j,� <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> �and Account Land Credit Land Total <br /> Facility Account Facility Credit Facillty Total <br /> Exempt � Yes � Na Haw Defermined 7ota!Amount G-�"� <br /> RESOURCE FEE ERU - <br /> 70TALAMOUNT <br /> Prepared By Checked By <br /> NO CERTIFlCATE OF C?CGUPANCY WILL B�iSSUED OR PINAL II�SPECTlON <br /> PEF2FGiRMED UtdTIL TI-iE TOTAL AMOUNTS l.15TED NAVE <br /> BEEN PAId AND <br /> RECHIPTED FQR BY A CEN'i'RAL PEFLMiTTiNG OFFICE OF PASCO COUPITY � <br /> Acknowlsdgement beiow does not impiy acceptance of concurrence,but slmply recelpt of a copy of this form,p4ac{ng <br /> the buiiding permit owner an notioe of thls assessmant and the conditions oE payment for same. � <br /> i <br /> DA7E REC6IVED BY <br /> RECEIPT NO. QATE BY <br /> � . � .. <br /> � _ <br /> �� <br /> � ,.-�_�.�--�-,.�.,_�,..,.«.�.-..�.____._�.._.� ____.__ ----- - <br />