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w <br /> :PA5CO_COUNTY, FLORIDA <br /> k' • <br /> .47 <br /> r�r <br /> Permit No. <br /> i, Date Permitted <br /> 'Bullder,Name/OwnerName ,2,. i v1i;8 Control <br /> County:Per'cel SubDiv: 0 <br /> Address/Locatlon3; V LL1 c!t <br /> ClassiflcatloMypeof:.Usg c r: <br /> TI AWPORTAMQICIMPACT FE fete: Sq.Ft Unit: ,399 <br /> Exempt (]Yes Q No How Determined <br /> imppct Fee.Amourtt .$ Zone No. TAM <br /> Accrount ;IMPACTFEE(056); Single*Famlly pstdohed House Amount $ „78 /1 <br /> ° (067} Mobile;Moat# <br /> Me). :0*11i'Resldential <br /> dYei-"0146' <br /> 23) :Collectin Fee <br /> Exempt How Determined <br /> PA' RK$'ANt3 RECREATIONFEE <br /> Lan1 Account Land Credit Land Total <br /> ftdriatlon Account Recreation'Credit Recreation Total <br /> Zone ., TOTAL-AmOUNT '' <br /> Exempt Yes ( No How Detaunlned <br /> LIBRAR. ME � ..—. <br /> Land:Acdcunf . Land Crt3dlt Land Total <br /> Facility Account Facility Credit Facility Total <br /> II <br /> Exempt ❑Yes ❑.No How Determined Total Amo 4 <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepered-By r Checked By <br /> NO.CERTIFICATE.`0F•.000.UPANCY WILL bF.ISSUED.'OR FINAL INSPECTION <br /> PERT D r NTiL TH.*,T,-T. Is:AMb0isi ftt:ISTED HAVE <br /> WON.PAIMAND. <br /> RECEIPTED.FOR BY A CENTRAL PERMIT IWG'Od FICE•OF PASCO COUNTY <br /> Ackr(owledgement below does not,imply aooeptanos of concurrence,but simply receipt of•a copq of this form,placing <br /> the bWlftg paimit owner,on notice of this assesament'and the conditions of payment for some; <br /> DATE -RECEIVED BY <br /> RECEIPT NO. DATE BY <br />