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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />-~-------.........."'...._-- <br /> <br />Permit No. .u_21J_~ TF1--..~-_. <br />Date Permitted ...J:>.LS,_a.J_ <br />Builder Name/Owner Name --K~1S~.i~.elaLS.._~.___ Control # __._____. .~_.~__~._.~~. <br />County PalcellJo, ..'~lt.~ 2 S::-_~_~.~..QoJ~-=.__9i&OV- ~_"'''f~ SubDlv: G./:::il.....Il..5?.::'-'..?Ck' '.> <br />Address/Location ."~.?3_<{1n~ .~rY_e_v., ts:>~"":1_._~_~ ._.._____~_ ._ __.._____.._._ <br />Classlflcatlonll.ype of Use_~_~_~J.e___l.::k-,-~e_~_._._____.._...~~__...._ _.__~___.____.~..~___ <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Rate: <br /> <br />.. Sq Ft Unit: _____.___ __~___ <br /> <br />Exempt [J Yes [7 No How Determined ---~---._--....~~---_...~,..-.__.__~.u_.__u_~_ <br /> <br />Impact Fee Amount ._.~.__Jt::L&!-:~:_.~)~.~ Zone No. ~___u~._.____ TAZ: ___._~...~_.__.~.._ <br /> <br />SCIIOOI~ IMPACT FEE~' <br />Account (056) Single-Family Detached House <br />(057) Mobile Horne <br />(058) Other Residential <br />i'12~1 Collection Fee <br />Exempt [J/Yes LJ No How Deterrnlned <br /> <br />. ~..-..-..._....---~........-... <br /> <br />Amount <br /> <br />$ <br /> <br />~_... ..---..".--.....-.. -"'-- -'- --... .-..~..- ..-,..-..... .....,._~'. <br /> <br />-----..~..__.._.___.,_A~ ___.......___~. __...~~ <br /> <br />._--..._--._._._---~--~-- .~.._..._.~._..._._- <br /> <br />PAR.<S AND RECREATION FEE <br />Land AccOllrlt Land Credit <br /> <br />Land Total.... <br /> <br />..-....- <br /> <br />F<screatlon Account Recr~g!jGfl.cre-(jlt _____._ Hecreation Total _..___._~___ <br />. .~..---.~--------~------.- -~_..-'.~ - <br /> <br />_/ <br />._- <br /> <br />_.~----- <br /> <br />ZUlle <br /> <br />./. <br /> <br />--.--- <br /> <br />TOTAL AMOUNT <br /> <br />...~.._._.._~...- ......--.. ...... .---.-- <br /> <br />Exell1l~t.. [JYes [J No <br /> <br />How Determined <br /> <br />':.-- ~ <br />Ii B RAR\lFEE'-.~-~- <br />Land Account <br /> <br />-----.--.------..-.--.-------..-.--..,..---.-.-.--...-..._---~.~--.._. <br /> <br />.-.------.-.. <br /> <br />. Land Credit <br /> <br />--~..-Larid Total <br />--=::~=---= ----~ <br /> <br />Facility Accuunt _.._..__~__._=_..EaeHltYcr~Ztlt _.._~_..~_.._.._.___ Facility Total <br /> <br />Exempt/[-.JYes ./[] No <br /> <br />How Determined Total Amount <br /> <br />------.--- .~--~- -.,...--....-.---..--.-- <br /> <br />-- <br /> <br />RESOUFi"CE FEE <br />TurAL AMOUNT <br /> <br />ERU <br /> <br />_._-_..~-_.. - .~._.._--_..---._-~-----..._-.- <br /> <br />-----.. --......-.----.-...------- <br /> <br />....."__'.n.'.............'"--...~..........._.._..~.~.~.,..........,,~.... . <br /> <br />-......a._....__________._ <br /> <br />Prepared By ....-.-.-..--....~.-.---~---~.___~m_~~_._ Checked By <br /> <br />__~._.n.______. _____._.______.______.._.__ <br /> <br />NO GEFHIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />Pl:RPORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br />BEEN PAID AND <br />REGEIPTl:D FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />Acknowledgement below does 110t Imply acceptance of concurrence, but simply receipt of a copy of this form, placing <br />Il1e building permit owner on notice of tills assessment and the conditions of payment for S8mB. <br /> <br />--"._~... '__"n - '_nO . .._..____._.~_.... ___._.'. -_'__'''_'''__h___~ <br /> <br />DATE <br /> <br />.-------_._--.~--_..- -- -.._----~..._..~..._-._-_._--. <br /> <br />RECEIVED BY <br /> <br />RECEIPT NO. L~~~k~-' DATE <br /> <br />BY <br /> <br />.-..-.-. ..._._._--~-- -- .. -_..-.~_.--.---- -..._~.---_.__.....~..__.._. <br />