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' PAS�t� C�UI�1`Y, ��.oRia� � <br /> e . ., . <br /> � � � <br /> . .. Permit No. �__� � <br /> Date Permitted � ,� <br /> Buiider NamelOwner Name ���t ���-- f'r�?�5't Control# <br /> S-� -2 2�� f0-OOQOd- `�o SubDiv: �l.�tht�.7"�r��, <br /> Caunty Parcei No. � 2 -6 <br /> Address/Locatian �j 7� �� � �+"��'i�.- K�1 Se--t� <br /> C(assificat(onfi'ype of Usa ������ <br /> 7RANSPORTATION IMPACT FEE � Rate: Sq.Ft Unit: �7�. <br /> Exempt []Yes ❑ No No�v Determined <br /> ' ic►zpact Fee Amount $ 3��a 2� Zane No. TAZ: <br /> SCHOQL iMPAGT FEE <br /> Account (056) Single-Family Detached House Amount $ r�'� <br /> {057j Mobile tiome <br /> (058) Otrier Restdenttai <br /> 123} Collect(on Fee <br /> Eacempt []Yes [l No How Detercn(ned <br /> PARKS AND RECREATION FEE <br /> land Account Land Credit Land Total <br /> Recreation Account Recreation Credit �Recreatton Totai <br /> Zane TOTAL AMOUNT $ ����-J�,C <br /> Exempt []Yes ❑ No How determined. <br /> UBRARY FEE <br /> Land Account Land Credit Land Tota) <br /> Facitity Account PaciBty Gredit FacilEty Tota1 <br /> Exempt ❑Yes ❑ Na Now Determined Total Arnaunt ����'"� }, <br /> RE50URCE FEE ERU <br /> TOTAL AMOUNT � � <br /> Prepared By • Checked By } <br /> i <br /> ; <br /> NO CERTIFICATE OF QCCUPANCY WILL BE tSSUED OR FlNAL IIdSPECTtON �, <br /> PERFORMED UI�ITIL,THE TOTAL AMOUNTS LiSTED HAVE i <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTlNG OFFICE OP PASCO COtlN'FY <br /> i <br /> 3 <br /> Acknowiedgement below does not tmpty accaptance of concutrsnce,but simpiy recelpt of a copy of this form,ptacing � <br /> the buiiding pertntt owner an notice of this assessmsnt and tha conditlons of payment for same. 4 <br /> t <br /> DATE RECEIVED BY <br /> RECEiPT NO. DATE BY <br /> � 1 <br /> C <br /> t <br /> { <br /> . . . .. { <br /> 6 <br /> ___-�.._._..�_..�.. _�-:_._ .s..:..'.. -�--�.—.� ..,_-_-' '_ <br />