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PAS�C) �C�UNTY, FLC)RILIA . <br /> ...' Permit No. f� t G'� <br /> Date Permitted -�j� <br /> Buitder Narne/Owner Name �'.�t��' ���7yc�'.���-Controi# <br /> County Parcei No. tl�,Zf �-�DO�o�--61)�Od"��7`vSubDiv: c�l GL�"��f7 __ <br /> AddresslLocation c.��''��� �.�'`t'�lc�° F< <br /> ClassificationfType af Use � <br /> 7RANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: �,2��` <br /> Exempt ❑Yes (� No Haw Determined <br /> ' Impact Fee Amaunt $. �t�o c�� Zone No. TAZ: <br /> SGHOOL IMPA6T FEE `/ <br /> Accaunt (056} Singte-Family Detached House Amount $ �,���� ' <br /> {057) Mobils Home <br /> {058) O#her Resldent(al <br /> 123) Callection Fee <br /> Exempt [�]Yes [] No How Datermined <br /> PARKS AND REGREATtON FEE <br /> �and AccounE Land Credit Land Total <br /> Recreatian Accaunt Recreation Cred{t Recreation Total <br /> Zone TO7Ai.AMOUNT $��p�<S G� <br /> Exernpt �Yes [, N4 How Determ(ned <br /> �IBRARY FEE <br /> Land Rccount Land Credit Land Tota) <br /> Facility Account Facifity Credit Facillty Total <br /> .� <br /> Exempt []Yes ❑ No How Determined Totai Amount�__ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUWT <br /> Prepared Sy �l��---` Checked By <br /> NO CERTlF1CATE QF�CCUPANCY W{L�BE tSSUED OR FINAL INSPECTIOt� <br /> PERFORMED UN1'IL THE Ti)TAL AMOUNTS LISTED HAVE , <br /> BEEN PAtD AND <br /> REGEIPTED FOR BY A CEM[TRAL PERMITTING OFFICE.OF pA3C0 COUNTY <br /> Acknowledgement below does not impty accaptance of concurtence,but simply cecaipt of a copy of this form,placing <br /> the bulldtng pesmft awner on notice of this assessment and th�a condltlons of payment for same. <br /> DATE RECENED BY <br /> RECEIPT N4. DATE BY <br /> �:z�..�.-.m. �- <br />