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<br /> <br />PASCO COUNTY~ FLORIDA <br /> <br />~~-) . <br />BlIildar N~.!IJ.fj/Owner Narne1 '(",.-1//&./)/ <br />COlH Ity r:'arcell'Jo. 3!/d ~--':2~:~:y.L!') .~ l Y )c:c:-~t)- [)2t!j SubDiv: ___________._____.__.___.__ <br />A'I 1- ',/1 ');' tl ) . 'Z" ./}_~ c:<) t:-/ / - ~/ //.. r,J V ....~: _j . <br />(C ItJS::; -( l i:l (11 ._. .-z:<.:.Z...--~-h--~L17?L-~.~--::;"+L~---------------------------_____ <br />Clabbificatloll/lype of Use___:~->7.~2_~) ':k')r::::Lj~ t/ ( l)~-/ I~;'k~_.__.__.,,____ <br />\ / , / . ~ <br />1/ . <br />TRANSPORTATION IMPACT FEE Rate: ___ Sq Ft Unit: ____________ <br /> <br />/? ;?cJ <br />Permit No. ----..!.:-:2-=-./______ <br />Date PermlHed ,Jl::Ji:--.()~_ <br />"I <br />l' <br />( "mt.5Z- . ___ Control # <br /> <br />Exempt [] Yet:; lX1' No <br /> <br />Ilow Determined <br /> <br />----------.---- -~-_.._,~-.._--- '-"..- .._---~---_.,-....-._".._- "'- <br /> <br />Impact Fee Alllount __~_hO /, _f 90 <br />,./);;r:/- Lj-{/1 <br />scff66L IMPACT FE:E <br />Account (056) Single-Family Detached House <br />(057) Mobile Horne <br />(058) Other Resldtllltial <br />1:123) Collpction Fee <br />Exernpt I.j Yes t:(1 No How Deterrnlned <br /> <br />Zone No. <br /> <br />TAZ: <br /> <br />---..--.- ",-. ---.---. "'-."- <br /> <br />Amount <br /> <br />/ / cy/"'--' / <br />$ -..-----.-jl--0...L.~--..-I2-L-.!l. -V. 0 "_J <br /> <br />----.._--~._---_..~-_..<-.... "'-.-..,- <br /> <br />-_..._M__________...,_.~..._._~_..__" <br /> <br />.PARKS AND RECREATION FEE <br />L.and Account Land Credit <br /> <br />-----~----_._.-._--.__._~-----_._-_..~_._--_._..._._.._-_.-.. <br /> <br />-----.--- --..-----..-.-.---- ...- --_'_r'~"_,,,,__,__,_ <br /> <br />Land Total <br /> <br />Recreation Account <br /> <br />Recreation Credit Hecreation Total <br /> <br />-~----_. ---_... --..._---._-_..~----.~ <br /> <br />Zone <br /> <br />TOTAL AMOUNT .._~_.__..._.________._____.._ <br /> <br />EX61llpt [J Yes [] I'-Jo <br /> <br />Illow Determined <br /> <br />....-._--'-~-~......-...'"'-'-~_....._--- <br /> <br />-- -~--._-._-. -_._._-._----_.._-_-.._---~--._,,-.._----_._-_.__._-----, ..--. -- -- .._---~.... <br /> <br />LIBRARY FEE <br />Land Account Land Credit <br /> <br />~---~--..._--,..~~.._....._--- <br /> <br />-.---. - .-... ----- -...-..---------..--. _...._---._-~--~---._- <br /> <br />Land Total <br /> <br />Facility Accoulll.._..___________ Facility Credit _________..______ Facility Total .._._______________ <br /> <br />~_. ,"- ---.... ..--.--.-..--......... - ...~--------~ <br /> <br />Exempt [] Yes [] No <br /> <br />How Determined Total Amount <br /> <br />-----..---- ------.-.-- <br /> <br />-- <br />RESOURCE FEE <br />TOTAL AMOUNT -L.lLIL..f----,d._;/ t/j . i):'$ <br /> <br />ERU <br /> <br />-..----- "'-"-'-'''~---- ----.- ~._--_.,...- <br /> <br />_...._~,_._--_._..y <br /> <br />...._~---- <br /> <br />Prepared 8y _ . _ _ _"m ________._ _ _ _._______________ _ Checl,ed By <br /> <br />----.- .._-----_._----_._--_.~---.._..._-_.---_._._._~--- <br /> <br />NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br />BEeN PAID AND <br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />Acknowledgement bt:llow does notlrnply acceptance ot concurrence, but simply receipt of a copy of thil; form, placlno <br />the IJlJilding perfllll owner on nollct:l of this asseSSllIdnt and Iha condlllons of paynltmt tor saIne. <br /> <br />--.- --~,-.._-- _._~ -'-"'-~-- ..--.--..--..-.- -----. <br /> <br />DATE <br /> <br />--RECEIVED BY----------------------n <br /> <br />RECEIPT NO. <br /> <br />-_..~ ---.-.---- <br /> <br />DATE <br /> <br />----.-..------ <br /> <br />BY <br /> <br />___do. .._.._.._~._..____..__.__.~~_.___.___ <br />