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, <br /> � � �= P�SCO G+�UNTY, �L�RID,��► <br /> r: <br /> � ` Permlt No. f�� <br /> Date Permitted _�� <br /> Builder NamelOwner Name ��/ttE,- �'���C- Control# <br /> County Parcef No. ��S=Z�F-�-'j-(}D 7p�QD31X1-15�l� SubDiv: C����'+� <br /> Address/Location i�d�- �Q�G�1'L Gcl�[Sc�.� �U <br /> Classificationfl'ype af Use �����t�L�/ �1�� <br /> TRANSPORTATiON IMPACT FEE Rate: Sq.Ft Unit: � <br /> Exempt �Yes � No How Determined <br /> � Impact Fee Amount $.��,�3�. Zone No. TAZ: <br /> SGHOOL IMPAGT FEE ,� <br /> Account {056) Single-Fami{y Detached House Amount $ T�(���� � <br /> � {057} Mobile Home <br /> {058) Ofher Restdentia! <br /> 123� Callecfion Fes <br /> Exempt [�Yas [] Na How Determined <br /> PARKS AND RHCREA710N PEE � <br /> Land Accaunt Land Credit Land Tota! <br /> Recreation Account Recreation Credit Recreation Tatal <br /> Zone TOTAL AMOt1NT $ `2�j���a <br /> Exempt [�Yes [� Na Now determined <br /> LlBRARY FEE <br /> Land Account Land Credif Land Tota! <br /> Facility Account Facility Credit Faci(ify Total <br /> Exempt ❑Yes [� No How Determined Tatai Amount �-�'" <br /> RESOURCE FEE ERU <br /> i"OTAL AMOUNT � <br /> Prepared 8y � Checked By <br /> NO CEFt7lFiCATE OF OCCUPANCY WiLL BE ISSUED OR FINAL(NSPEGTION <br /> PEi2FORMED UNTIL THE'ftlTAL AMOIlNTS LISTED HAVE <br /> BEEN PA{D ANQ <br /> RECEIP7ED FOR BY A CENTRAL PERMITTING O�FICE OF PASGt?GOUNTY I <br /> Acknowiedgement below does not impiy acceptance of concurrenae,but slmply recalpt of a copy of this form,piacing <br /> � the bulld{ng permit owner on notfca of this assessment and the cond(tlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> .�.���,�,.�r� - ___. <br />