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.,, <br /> ; I�A��� ��U6��'�', �rL{�R�D�A <br /> t - j �''/ <br /> � Permit No. '��te G <br /> Dats Permitt�d � <br /> Butider NamelOwner Name F.P�tn.�l�� 4��8�� Contro!# <br /> GouMy��fceTNCF:'•� �lt��t'��ui���,l����t�bpiv: c:�, ���Q+� �' <br /> � <br /> Aa�����atr'� -�C�z�-- �.6lGz. <br /> •�,''�'�`� -�- <br /> CiassiflcaHon/Type of Use � �• <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: �–�3(p� <br /> ';� Exempt [�Yes [] No How De#ermined <br /> �: � Impact Fee Amount $. .���3'Z-•th� Zane No. TAZ: <br /> ` � SCHOOL 1MPAGT FE@ <br /> �;:- � Account (056} Single-Family petached House Amount $ �(�'j7(v� 2-� <br /> `"� (057) Mobile Home <br /> �- <br /> �� ".: (058) Other Residentiai <br /> � � 123) Coilectlon Fee <br /> r- <br /> '� . Exempt [�Yes Q Na How Determined , <br /> ' �PARKS AND RECREATION FEE <br /> _ Land Account Land Credit Land Total <br /> Recreatian Account Recreatian Credit �Recrea#ion Tatal <br /> Zone TOTAL AMOUNT $ '-]���$�, <br /> , ' Exempt ❑Yes ❑ No Mow Determtned <br /> �' L18RAC�Y FEE <br /> '�, Land Account Land Credit Land Tata( <br /> Facility Accaunt Faciilty Cred(t Facility Total <br /> .. Exempt ❑Yes ❑ Na How Determined Totat Amaunt c=�____ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT "-� � <br /> � <br /> Prepared By Checked By <br /> I , NO CERTIFICATE OF OCCUPANCY WILt BE lSSUEU OR FIRtAL iPiSPEGTiOIV <br /> PERPORMED Utdl'IL 7HE 70TAL AM�t1NTS USTED HAVE <br /> , , BEEN PAiD AND <br /> RECElPT�D FOR BY 1�CENTRA�PERMI'CTING C��FICE�t)F PASCO COUNTY <br /> ,- <br /> ' Acknowiedgemant balow does not impiy acceptanca of concurrence,but simply recetpt of�a copy of th(s form,piacing <br /> � � ths buftding permtt ownar on noUce of this assessmant and thQ canditions of payment for same. <br /> . <br /> �I <br /> �, RA7E RECEtVED BY <br /> � � - <br /> � ' RECEIPT N0. DATE BY <br /> � <br /> __—_--- --. <br />