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_ -�e'��;-��;�:".✓�'�' <br /> � <br /> � ���7�d� �1/6JI���g �����1�� <br /> �_ , Permtt No. � { �b� <br /> Date Permitted 2-��5-(� <br /> 18uilder Name/Owner Name ��"-� �'�� Controi# <br /> Gounty Parcel No. �-��c.���-0(3����Q��-/fll Q SubOlv: �{�CRCCOt,'Q,9t_� <br /> �I ,. Address/Location �J Z 3 y vwf.�lG�.� � ��a� �12- <br /> 1 �;: , � i <br /> � {; CVassificatlon(f'ype of Use �,� ,�, Gi <br /> � � � —T <br /> E`;;�. TRANSPORTATtON IMPAC?F�E Rate: Sq.Ft Unit: 3��Q�� <br /> ,�s� <br /> ��': Exempt [�Yes [� No Haw Determined <br /> I, � Impact Pes Amount $. ���p 3��� Zone Na. TAZ: <br /> ; �;, <br /> �`�., <br /> b„� SCHOC?L iMPA�T�EE <br /> :r;,;: Account {056) Single-Family petached Nause Amaunt $ �� �uy�� <br /> (057} Mobile Hame <br /> {058) Other Residentiai <br /> Y� 123) Coliection Fee <br /> ` Exempt [�]Yes ❑No Haw Determined - <br /> �' PARKS AND RECREA71t?N PEE <br /> Land Account Land Credit �and Totat <br /> Recreation Accaunt Recreatian Credit �Recreation Tatai <br /> Zone TQTAL AMdUNT $ �(���-5,�v <br /> -� Exempt [�Yes ❑ No How Determined <br /> i - <br /> UBRARY FEE <br /> r.' Land Accaunt Land Credit Land'fotai <br /> i Faclifty Account Faciifty Credit Facility Tatai <br /> Exempt []Yes ❑ No How Determined Tatal Amaunt�_____ , <br /> RESOUE2CE FEE ERU <br /> � TO7AL AMOU�iT � � <br /> � <br /> I Prepared By Checked By <br /> ��� NO CERTIFICATE+DF OCCUPANCY WILL BE 133UED OR FINAL tNSPEGI'ION <br /> � PERFORMED UNTIL THE'T07Ai..AMLlllNTS l.ISTED HAVE , <br /> � BEEN PA{D AA1D <br /> I _ RECEtPTED FOF�BY A CENTRAL"PERMITI'ING OPFICE OF PASCO Ct3UNN <br /> �� ` Acknowiedgement below does not impty accaptance of concurrence,but stmpty receipt of a copy of this form,plactng <br /> � the bu4ding permit awner on notice of thls assessment and th�conditions af paymeak for same. <br /> i • _ <br /> i <br /> i, . <br /> '� �� DATE RECEiVED BY <br /> � . <br /> RECEIPT NO. DATE BY <br />