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<br />PASCO COUNTY, FLORIDA
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<br />--......-
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<br />"-<-
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<br />,(-/ ,.I .,'
<br />(tlllildor N-me/Owner Name - .-~~ ":W"r . Control # ____.______._
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<br />ClIlIIIly Parcel No. . .3.1-.2.2::'.2!::(/LtJLL~)/., . {:Yii! SubDiv: ______._._________
<br />. ~. "'r ' (~ " c') / /} ( j
<br />Adelre5s/1 Dcailon - - _no .il?/.--,~~1ti!... (/". .,~'C -l <l-'--__ ____
<br />
<br />CiasslflcaliolllTypa of Usa ~"_\, {!<L91,-(~LL1-i.L!<lli(~____.___._._____
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<br />TRANSPORTATION IMPACT FEE Raia: /7 . Sq Fi Uuit:
<br />-"---'-,----- ----.----,-..,-------.
<br />
<br />--" ,- )
<br />Permit No, ------L<-J_.:.€._CZ,____
<br />Date Permltled ....Lf?:~=?.~~ (),~_
<br />
<br />Exernpt [] Yet:i~J No
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<br />Irnpacl Faa Amount. $-i.:fKy_.....__.
<br />
<br />SCliOollMPACT FEE ' ~( ~)r
<br />ACcount (056) Single-Family Detached House
<br />(057) MObile Horne
<br />(058) Other ReslcJential
<br />.i12::S) Co/Jection Fee
<br />Exempt IJ Yes ~?/ No How DEiterrnlnecJ
<br />
<br />PARKSAAh RECREATION FEE -
<br />Land ACcount Land Credit
<br />
<br />Ilow Determined
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<br />--_..-._~"-----_._~-
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<br />. .----.------ '.---...--..-.----,--...-.. --..----
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<br />Zone No,
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<br />-.--.-----
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<br />TAZ;
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<br />--"----._-._-_._.~
<br />
<br />Amount
<br />
<br />/1
<br />
<br />$ -.--/~2-f!--""j;lg,_kr
<br />
<br />?'
<br />
<br />--'_.~.~--_.__._-_...--..._-~,._.., _....
<br />
<br />-- -~- ....---'-.---..------- '._~------~-..
<br />
<br />-.-------......----..---'--------,----.------....,-..---,....-..
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<br />-----.--- ---~.....----._-_.-.
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<br />. -'-- - .-._-----._._--_._~
<br />
<br />I~ecreation Credit Hecreatlon Total
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<br />------ --'....--..'..,....----,....... --..,..,
<br />
<br />Land Total
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<br />RecrBation AccCJlmt
<br />
<br />Zone
<br />
<br />... - ~._._----._..._---_.-
<br />
<br />-'-----..-- --'-..,..._-,--
<br />
<br />Exenlpt [] Yes C] No
<br />
<br />LIBRARYFEE--------
<br />LcHld Account
<br />
<br />How Determined
<br />
<br />TOTAL AMOUNT.. .-.L..____,_.._,_,_ '.__.._
<br />
<br />--'----~-'------._-~
<br />
<br />------,-.. --'--- -- ._,-- -----" -.--.--..-....-..... --. --, -----
<br />
<br />". - -_._-----._~
<br />
<br />Land Credit
<br />
<br />--....--------
<br />
<br />Facility ACCCJlHlt __.____________ Facility Credit
<br />
<br />----.----.---.- --------
<br />
<br />Land Total
<br />
<br />n..____..._______...-._____ ._ ~_ _'__. _"'_._
<br />
<br />Exempt [) Yes /-J No
<br />
<br />I low Determined 'fatal Amount
<br />
<br />Facility Total
<br />-.-'-.--------.....-- .----.....-.----
<br />
<br />--_._-----~-- ~------
<br />RESOURCE FEE ,;I
<br />',--c.")'/-Al.. AM(') (Jr.,-,. -!/ a /'... ~ ..!/ :<'." 12"'" =
<br />. I '/ -___I_~,: J.,.<: (d..'i2-~__~ /c ...)_,
<br />
<br />----..,----- ---....-.......--.-.---------
<br />
<br />ERU
<br />
<br />-....-------~_......._..__.---....._---~.--~_.....--~
<br />
<br />_._----_._'~-_.~_.-.---- ~._'--.~-.
<br />
<br />Prepared 8y ........ ......_____________.__.. Chaci<ed By
<br />
<br />'"""""---...._~
<br />
<br />----.--------.-....~
<br />
<br />NO GERTIFICATE OF OCCUPANCY Will BE ISSUED OR FINAL INSPeCTION
<br />PERFORMED UNTIL THE TOTAL AMOUNlS LISTED HAVE
<br />BEEN PAID AND
<br />REGEl PlED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
<br />
<br />---------~--_._-_._---_._-,........_-_.._,-_._-
<br />
<br />AChnowl'dg'lllanl b,low do.s "olllllply aCC'PI.nce ot co"curranc., but slmpty r.catpt or a copy at Ihts form, placing
<br />Iha bUilding parmlt own.r on noltc. at U ,I. a".""..,,1 'nd Iha conditio", at paymanl tor '.ma,
<br />
<br />---- .-.....---.-..---.--..----....-..---..-.-------
<br />DATE
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<br />RECEIPT NO, DATE
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<br />-RECEIVED'BY ----'------------,--___,
<br />
<br />-----'-,..-..-.----- ----------_h_
<br />
<br />BY
<br />
<br />-----. - -------......-------- -- --. ------.~_..-.--------.-- - "--,...-..
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