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— - � -� <br /> ' �d1a7`r�A 6a��Atl� 6 � tl�'�..4►�NIt.A�. <br /> . ' � � Permit Na. � �"�� ^ <br /> Date Permltted -3 't� <br /> � Builder NametOwner Name �F�t�r'�%�I�� Control# <br /> Gounty Pareei Na a�-��--D()��--�0`�p--(Sl�p SubQiv: c.�i�L1e.rr�Lca_ <br /> ;:_ Address/Locatlon � �' Z� �"a�'�r1 ��'`'�E-� �L <br /> ��� Gtassiflcaflon(Type of Use _S���'�'�e�.�Y ly�_ ,. <br /> ;yG <br /> � TRANSPORTA►TIORt iMPACT PEE Rate: Sq.Ft Unit: 3,�(�j <br /> �`t= <br /> ��� � <br /> �`�� Exempt [�Yes ❑ No htow Determ(ned <br /> +� <br /> ' Impaat Fee Amount $. ��0�' Zone No. TAZ: <br /> K`.. <br /> �S, � <br /> ,� , sc�oot,impacT F�� <br /> %:-� Account (056) Singie-Famity Detached House Amount $ �t�'Zro�� <br /> � <br /> (�"; (057} Mot�i(e Home <br /> ;_ . (058) Other Restdentfat <br /> 123) Colleotlan Fee <br /> ; Exempt [�Yes [] No How Determined <br /> � PARKS AND RECREATiON FEE <br /> Land Accaunt Land Cred{t Land Total <br /> Recreation Account Recreatian Credit �Recreation Total <br /> Zone TOTAL AMCiUNT $`Z�g-v�� <br /> Exempt ❑Yes ❑ No How Determined <br /> "'- LIBRARY FEE � . <br /> , Land Account Land Credit Land Total <br /> �` Facility Account �acility Credit Facllity Tota1 <br /> �_, <br /> '" Exempt ❑Yes ❑ No How Defermined Tota#Amaun�� <br /> ;�. <br /> � � RESOURCE FEE ERU <br /> TOTAL AMOUNT `> • <br /> Prepared Sy Checked By <br /> !VO CERTtFiCA7E�F OCCUPANGY WiLI.BE ISSUED OR FiNAL tNSPECTtON <br /> � PERFORMED UNTlL THE TOTAL AMOUNTS LtSTED HAVE <br /> � BEEN PAtD APib <br /> �� REC�tPTED POR BY A CENTRAL PERMiTTtNGt O�PICE OF PASCO COUNTV <br /> � E <br /> ';. Acknowtedgement below does not tmpiy acceptance of concurcence,6ut slmply recetpt of a copy of thls form,,ptacing <br /> the buflding permit ownar on nodce of thts assessment and thQ conditions of paymant for sama. <br /> DATE RECEtVED 8Y <br /> � RECEIPT NO. DATE SY <br /> ( <br /> =�_�,�s�,�..v_--`._.�_ - - .�x �=t.._ <br />