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� � � - � PAS�� �����'Y, ��.�1R1�►�►► <br /> . .`� � Permlt Na. �� <br /> pate Permitted ��7_$_ <br /> Builder Name/Owner Name t,,P�rn rtld.r- ��'�`�8 Control# <br /> County Parcef Na. �.��Zfi— Z/�j'j(�Rn..PJc�C.��3`�'U SubDiv: �t�o[e11 �� <br /> AddresslLocation �ZZ-1 ��t,�dPl� �o��Q� CUe- � _____ � <br /> GlassificatloNType of Use �9 ytGi t���l�f , <br /> TRANSPORTA7iON tMPACT FEE Rate: Sq.Ft Unit: ��, 37�- <br /> Exempt � []Yes [] No Haw betermined <br /> � impact Fee Amount $. 3�3Z- Zone Na. TAZ: <br /> SGHOCtL{MPAGT FEE <br /> Account (056j Singfe-Famtly Detached House Amount $ �(��'(p�2� <br /> (057} MobtIa Home • <br /> {058) flther Resldential <br /> 123) Collection Fee <br /> Exempt �Yes [�No Fiow Determtned <br /> AARKS AND OtECREAvft1N FEE <br /> Lar+d Accaunt L.and Credit Land Tota1 <br /> Recreation Account Recreation Credit �Recreatian'Total <br /> Zone TOTAL AMC?UNT $ ��q� �ib <br /> Exempt (�Yes ❑ No How Determined <br /> liBRARY FEE <br /> Land Account Land GrediE Land 7otai <br /> Facitity Account Facifity Credit Faciiify Total <br /> Exemp# (�Yes [� iVo How Determined Tatai Amount �� <br /> RESOURCEFEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTtFtCATE OF OCCUPANCY WiLL BE tSSUEQ OR FtNA!INSPECTICIN <br /> PERFCIRMED UNTiL THE TOTAL AMOUNTS LlSTED HAVE <br /> BEEN PAID AND . <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO CQUNTY I <br /> Acknawtedgement betow does not Imp1y acceptance of concurrence,but simpiy receipt of a aopy of this farm,placing <br /> the buliding permft owner on nottce of thls assessment and th�conditions of paymant for sams. <br /> DATE f2ECEtVED BY <br /> FtECE1P7 iVO. DATE BY <br /> , <br /> �.��•-.�=n-�,.�. .��-�..�. <br />