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<br />PASCO C()lJNT\' FlJORII}A
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<br />Builder Name/Owner
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<br />,ame ~~-':~f--.......~t~
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<br />County ParCl'l ,~,
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<br />Location ~ ~
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<br />(,la~\lfiC,l!inn!l vpe'
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<br />TRANSPORT.\TJON 1~'f'ACT FEE CALCUtA J '
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<br />f\\-\11'1
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<br />Rate j,
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<br />Sq PI Tn.: -
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<br />I"'p,r~"" q,
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<br />Impall Ft'p Amnunl ~
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<br />The ,'oo\e "npact fee h t'n established purSUdl':
<br />by the Board of C y Comml' .onC'f' Th,\ 3,1">(>( ,,'
<br />,IIV': the perm' ...' , -',ilure
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<br />RESOURCE RH (1\ ER Y ASSI
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<br />lENT
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<br />RFSt))FNTI A L
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<br />No" Ullll~
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<br />Rate/ERU
<br />
<br />"5) ()()/Year
<br />'" $0 ] 42 Dol)
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<br />i R\' "',..~r\ "\,,
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<br />4,,,,,"vnCI1!-- l","n Un,r~\ ~ ,~i
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<br />HYL\L fEE 'S
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<br />T"T .~~",q~ d\<;(",,'ne nt ho" het"n l.'<;tabh"hc(l pu r;ll<.tnr {r." r","'
<br />~lS rr.p:!tlt"ncled
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<br />THE- ASSESSMENT WILL BE CAt f",'LA fEr)
<br />Dee t., r lI, l\;('Y
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<br />~()CERT1FKATl:,OFOC('tJ>A:'iC\' OR FT\AI. P()\H.R RFLEA'~r. \\1 , !" .,'. I", \1 ! '!'
<br />HAVE 8[[:\ PAID AND RECEIIYffD FOR BY \ ( I',! l< \1 ILK\lIl. , ";' t I ' ": ' \."
<br />
<br />.11" '" 1 ~., l.bl !' .
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<br />Acknil\A>l~dgt'fTlcm tlelow does nN Impl: d~'(eplar" e ,"1:(',,'.':0('.'" t>-.l'ln1ri" ft'U:lpt ()f a copy 0. :hlS form, placing
<br />the buddmg permit owner on notice of this assessment and the conditions of pavm('nt for same"
<br />
<br />Dale
<br />
<br />ReCClved By
<br />
<br />OFfiCE USE ONLY
<br />
<br />TRAN~PORTAT10N REC" NO"
<br />
<br />DATE
<br />~.6 1 Qi::.z__ i 'An:
<br />
<br />1~-31"'/~_
<br />
<br />RY
<br />BY
<br />
<br />"=;;h
<br />
<br />RESOURCE RECOVERY REC. NO
<br />
<br />WIllIe
<br />AppliClInl
<br />
<br />Canary
<br />T ranslfm."ee
<br />
<br />c.nary
<br />RFI/Finane.
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<br />Pi",k
<br />')" -e
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<br />Gr,.n
<br />~!rlgl''''p
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<br />f.acal:c.
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