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i .: <br /> � �;� - _ � <br /> � � � <br /> � � �: pAsco coutv-r�r; F�o��aa I <br /> . ' Permtt No. � .,�''l <br /> � � Date Permifted <br /> i / <br /> Huilder NamelQwner Name �2P+-tt�' �� Controi# <br /> . ounty Parcef No. �-�—Zl���Q-Dl>3DD^DO�U SubDiv: �l� <br /> ` ;ddress/�ocation tt�J �LI��P'1 �t�'!�[��l `sr <br /> � � � t , <br /> � IassificafiontType of.Use �! e r <br /> RANSPORTATIt3N IMPACT FEE . Rate: Sq Ft Unit: � <br /> � �xempt ❑Yes ❑ No Now Determtned <br /> . � <br /> `mpact Fee Amaunt $3�(o �2.t?t� Zone Na. TAZ: <br /> 'SCHQOL IMPAGT FEE <br /> Account {456) Si�gte-Family qetached Fiouse Amount $ � 7�. Z-� <br /> ' (057) Mobile Home <br /> (058} Ot�er Residentiat • - <br /> 123) Coflectfan Fee ` <br /> Exempt [�Yss � No iiaw�Qetermined <br /> � � t� <br /> � PARKS'AND RECR�ATtON FEE �'�~ <br /> � and Account Lartd Credit �Land Tota! ! <br /> .�.�_._ <br /> . .. �• ecreatian Account Recreation Credit „� Recreatton Total ___�_.__ <br /> ! <br /> - � I one • TOTAl.AMOUNT $ � � 'J� <br /> IExernpt ❑ Yes (� Na Haw Determfined ' <br /> � L[BRARY FEE <br /> , ( �.and Account Land Credit - Land Total <br /> i - <br /> �acility Account Facillty Credit Facility Totat , <br /> �xeinpt ❑Yss ❑ M1fo How Determined Total Amount���� <br /> �tES01lRCE FEE ERU <br /> � 'CdTAL�AMOtlNT ' <br /> Prepared By Checked By � <br /> i <br /> I ' I <br /> NO CERTtFiCATE OP OCCUPANCY W!L!BE ISSU.Ep OR FINAL INSPECTION � <br /> PERFORMED UFfTiL 7HH TOTAL AMpUNTS l.ISTED HAVE � <br /> BEEN PAId AND ' <br /> RECEIPTED FOR BY A CEt�lTRAL PERMITi'INfa OFPICE�OF PASGO GOUTlTY �j <br /> � <br /> knowledgement befaw doas not impiy acceptance of concurrence�but simply recelpt of a copy of this fartn, lacing <br /> the building permlk owner on notice of this assessment antl tha conditions of payment for same. <br /> I I' <br /> � � I <br /> I <br /> DATE ��T RECEIVED BY <br /> RECElPT NO. DATE i BY { <br /> � <br /> � <br /> � ` <br /> � <br />