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1 <br /> "�. •.�, , <br /> . �. , <br /> : <br /> � � ; �� � �: +'; c����� ��u�����, ����r��► � <br /> ;.. .. . . <br /> � ' �� Permit No. ��— <br /> Date Permt�ted � -2(o- <br /> Buiider Namel4wner Name Control#' <br /> Gounty Parce{ Na, t J tJ�p–2.�� ��p��-�C?-�Z"7('� SubDiv: ��U�`�O � <br /> AddresslLocatian to 77� �Zr'Cc- �-.�`�'� ��- <br /> - ClassificationlType of Use i <br /> 1'RANSPORTATiON It�PAG�' �EE Rate: Sq Ft Unit: ��<�c'3, � <br /> �.J <br /> ;� ` Exempt [] Yes ❑ No Mow Determined <br /> ;.` <br /> -- � impact Fee Amount $.�.� � �J 2� Zana No. TAZ: <br /> ��i� SCHfJOL fMPACT FEE � � <br /> j::` Accaunt (Q56} Singie-Family Detached House Amount $ _ `` '���, <br /> ,,,: <br /> � {057) iVlobiie Home <br /> ; {058) Other Residentfai <br /> 123} Coiiection �ee <br /> Exempt [� Yss [] No How Determined <br /> PARKS AND RECR�ATION PE1� <br /> Land Account Land Credit Land Tata! <br /> Recreatian Account Recreatian Credit �Recreation Totai <br /> Zone T4TAL AMOUNT $ ���'4 S,� <br /> Exempt ❑ Yes ❑ No How Determined <br /> L.iBRARY FEE <br /> -. Land Account Land Credit Land Totat <br /> � Facility Account Faciiity Credit Facility Totaf <br /> Exempt ❑ Yes [� IVa Naw Determined Totai Amoun��=��� <br /> RESOURCE�EE ERU <br /> TOTAL AMOUNT � <br /> Prepared By � Check�d By <br /> WO CE�Ti�iGATE OF OCCURR�iMCY ti�tiLL BE iSSUEC! OR PINAL INSPEGTI�N <br /> PER�ORMED UNYII.7HE TO'TAL ANIOUNTS LISTED HAVE <br /> . ���N PAIC► AND <br /> RECEIPTED �OR BY A CENTRAL PERMI`�'t'ING 4fiFiCE�Ofi PASCt}COUNTY � <br /> � <br /> - Acknawiedgamsnt below does not impiy acceptance of concurrence,but stmply recalpt of�a copy of this farm,plac►ng <br /> the butlding permit owner on notice of th{s assessment and th�condltions of payment far same. <br /> ' 1 <br /> DATE � RECEIVED SY <br /> RECEIPT N4. DATE BY <br /> ________---_: <br />