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, � PAS�O C�UNTY, �FLORIDA <br /> . . t � Permtt No. l �qd� <br /> Date Permitted to--h,J7 <br /> Buitder NamelOwner Name �' �� Cantral# <br /> �i County Parcai No. tS-Z�-Zt-��-�D--C�C�-0 --- SubRiv: �Ci.(RU.��Zl�W� <br /> � AddressJLacation �'7��� T�t`F� ���C--�� <br /> Classificattanff'ype of Use �t,t7v� �dY�2, <br /> fiRAN3PORTATiON IMPACT FEE • Rate: Sq.Ft Unit: ��'a� �, <br /> Exempt ❑Yes ❑ No No�v Determined <br /> � Impact Fee Amount $ .�r� �2� Zone tVa. TAZ: <br /> SCHOOI.tMPAGT PEE � <br /> Account (056j Singie-Family Detached Nouse Amount $ <br /> (057) Mobila tiome • <br /> (p58) Other ResCdentiai <br /> �23) Coltectian Fee <br /> Exempt (�Yes C1 No Now petermined <br /> PARKS AND REGREATiiJN PEE <br /> Land Account Land Cred(t land Tata1 <br /> Recreation Accaunt Recreation Credit �Recreation Total <br /> Zone 70TA�AMOUNT $ �&�-��o <br /> Exampt []Yes [] No Haw Determined <br /> LtBf2ARY FEE <br /> Land Accaunt Land Credit Land Total <br /> Faciiiry Account Faciiity Credit �acitity Total <br /> Exempt ❑Yes ❑ Na How Determined Totat Amaunt� �' <br /> RESOURCE FEE ERU , <br /> TOTAl.AMOUNT �; <br /> � <br /> � <br /> Prepared 8y , Checked By � <br /> ��•� j <br /> �--- <br /> NO CERTIFICATE QF OCCUPANCY WILL BE tSSUED t}R FINAL{NSPEC710N `� <br /> PERFORMED UNTlL Tk1E T07AL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> ' RECEIPTED FOR BY A CEtdTRAL PERMITTINC,�O�FICE.OF PASCQ COUNTY <br /> � <br /> Acknowisdgement below does not impiy acceptance of concurrsnce,but simpiy recetpt of a copy af this form,ptacing � <br /> ths bufiding permit owner on notice of this assessment and fh�conditlons of payment far same. <br /> DATE RECEfVED SY <br /> REGElPT NO. DATE BY <br /> � ��_�._ti��-o.:�-=------� <br /> _�.t�-_�.:,a:��� <br /> .�:.�:.�-=.�...-.�>��_.--=-=-=�-,. <br />