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<br />. '" ,._.,,""'h'f~~- -,' ~ -,___ <br /> <br /> <br />PASCO COUNTY, FLORIDA <br /> <br />-.... - <br /> <br />Permit No. --..LZfl _ <br />. Date Permitted + - ,- 0 ":3 <br /> <br />Builder Nerne/Owner Name J~~ Control # ___~ <br /> <br />County Parcel No. c3._1..~:;5~L:~.LJ..QiD-Q;22()O- iT /Jh?. SubDlv: ________.___ <br /> <br />Addless/l.ocatlon cl--2'--L1._.d~~__. _____ <br /> <br />Classification/Type of Use -,-.l'~l1J~L_~_____ _________ <br /> <br />TRANSPORTATION IMPACT FEE Rate:_ Sq Ft Unit: _________ <br /> <br />Exempt [I Yes S"NO How Determined ______________________________ <br /> <br />Impact Fee Am,ounJ..J-L f~9./-)_____ Zone No. TAZ: _.._________ <br />"U4f.. 1-- t:,.-o ~ :zgi.? <br />scrrootlM~CfFEE (' -- ---- ______ <br />Account (066) Slngle~Famlly Detached House Amount $ --'-.----._____.h._.____ <br />(057) Mobile Home _____________._ <br />(058) Other Residential __________..______ <br />-~3) Collection Fee <br /> <br />C:::A;:::'R~~:N FE:OW Determined ------------- <br /> <br />Land Account L.and Credit Land Total <br /> <br />--.----.---.---. ---.-- <br /> <br />Recreation Account Hecreatlon Credit <br /> <br />-----------...--- <br /> <br />._...._--~- -~-_.__.- <br /> <br />R.ecreatlon Total <br /> <br />lone <br /> <br />..'--...--------.--.-.-. <br /> <br />TOTAL AMOUNT _L______._____~_ <br /> <br />F-xernpt [] Yes [J No How Determined <br /> <br />llSRAAYFEe'~-'--'- . <br />balid Account Land Credit <br /> <br />---.---------------.-----.-----. <br /> <br />-.....-- <br /> <br />-- <br /> <br />-----------.. <br /> <br />Land Total <br /> <br />-.-----....-.-...--..- --------.-- <br /> <br />Faelllty Account __________ Facility Credit ______ Facility Total ,_ <br /> <br />-.---...---.---- <br /> <br />Exempt [] Yes 0 No How Determined <br />ResouRCE FEE M"_'_~____ --,-- - <br />lOTAL AMOUNT <br /> <br />---~-.~- -~---- <br /> <br />Total Amount <br /> <br />---~......-.. <br /> <br />ERU <br /> <br />-----.------ <br /> <br />~.....,--..,--;.,....;,.......-...........,-----_.._,-----._----_. <br /> <br />.---------- <br /> <br />PrSl1ared By ___H___________________________ Checl<sd By __._____.____._______ <br /> <br />NO CER'T1~ICATE OF OCGUPANCY 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 />Aokhowledyement beloW does 110t Imply acoeptance of concurrence, but simply receipt of a copy of thla form, pfacln(j <br />tlie bulldlnrJ permit OWher on notice of ttlls assessment and the conditions of payment for same. <br /> <br />bATE~~~~~~---i.--A/jJ/~1fl .~__ -RECEIVE~,B'y ------ <br />RECEIPT No. f.tXi 1.;;5 ;fOAtE '2-/~~y ~-.J...C..R__ <br />