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- «' � <br /> '•, <br /> ,.,, . <br /> : ��►►��C� ��U�lTV, F�.�fR1�1�► <br /> r� <br /> �+ �� Permit No. � ��'� <br /> Date Permitted - � � <br /> � <br /> Buiider Name/Owner Name �At�� ��d. � � Gonfrol# <br /> Caunty Parcei Na. ���p-Z-�— f��- C���- �� SubDiv: Gt� f'�Gt,��f� <br /> AddresslLocation c�j ���'t" `t'��friL iC.G1�t'_ �-� � �` �' �p cs <br /> Glassification/Type o€Use T U�(1 �(�`�'- <br /> ' <br /> TRANSPORTATION IMPACT FEE Rate: Sq �t Unit: � 1 � � � <br /> Exempt [] Yes [] No How Determined <br /> I � impact Fee Amount $ �c `C�t�= Zane No. TAZ: <br /> SCHOdL.IMPACT�E� <br /> I Account (Q56} S9ngle-Family Detached House Amount $ �� <br /> (057) Mobi(e Hame <br /> � {058� Other Residentia! <br /> 123} Cofiectian Fee <br /> Exempt [] Yes [] No How Determined <br /> �ARKS AND RECRE�4TION FEE <br /> Land Accaunt Land Credit Land Tatai <br /> Recreation Accaunt Recreation Credit Recreatian Tota1 <br /> � Zone TQTAL AMOUNT $ ��p� �,� <br /> Exempt � Yes ❑ No Haw Determined <br /> LIBRARY FEE <br /> Land RccounE Land Credit Land Total <br /> �acility Account Facifity Credit Faciiity Totai <br /> �', Exempt ❑ Yes ❑ No Haw Determined Totai Amount �,,� _ ; <br /> ' �I <br /> RESOURCE FEE ERU ' <br /> TOTAL AMOUNT e f � � <br /> Prepared By Checked By <br /> NCl GERTIFfCATE C}� OCCUPANCV lMILL BE ISSUECI t3R FINA� INSPECTiON <br /> PERFORMED UNTIE.THE TOTAL AMOUPlTS LISTED HAVE <br /> BEEC� PAID AND <br /> RECElPTED FUR BY A CENTRAL PERMiTTING OFPICE OF PASCO COUNTY <br /> Acknawiedgement below daes not impiy acceptance of concurrence,but slmply recelpt af a copy of this form,placing <br /> the build'mg permit owner an notice of this assassment and thQ conditians af payment for same. <br /> / �� � ����-�- <br /> DATE RECE! Y <br /> RECEiPT NO. DATE ! � BY <br /> , .. . .. i <br />