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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />---"'....,._~ ~- <br /> <br />_.--......... <br /> <br />Penult No. ~ 7 <br />. Date Perrnltte-eJ _- ~;2~;J ----- <br /> <br />Builder I,ame/Owner Name _yj /la0.'~.J~~ Control # _'_._" ....._._ <br /> <br />Counly Parcel NO..J.'f.- -;? s.~'2>J~_b "'I 0 _:.pj.:.t'V" t'TT:> ~bDIV: r;;J'i.."-~_~" ~~ 0 '^ 5 <br /> <br />Adclressll_ocatlon ---:,3.:2 ~~3.R-__~!!./'lr?_~~--.L1_!!_f_.~________________________~_ <br /> <br />Classifica tlor1IType of use-------1fl~.k:&_nJ/:?z~---____________________u________ <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Exempt <br /> <br />[J Yes [~~/ <br /> <br />Rate: ________ Sq Ft Unit: ________ <br /> <br />How Determined <br /> <br />f1"''(') <br />Impact Fee Amount --~--____4ttD -______ <br /> <br />--------.--.-..----~.------__h..__.________._._..___ <br /> <br />Zone No. T AZ: <br /> <br />--'------- -_._~.--_._-. '..----.------ <br /> <br />.sciToOLIMPACffiE . . --._~- <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />J-123 t Collection Fee <br />Exempt L~Xes IJ No How Detennlned <br /> <br />---~.......--..--.............._............,--..-..-_-----_...- <br /> <br />Amount $ <br /> <br />-------... -__'h"____.__..__.__ _ _,.~..___....~.__..~__~__ <br /> <br />--~_._---._--._._--_.._.~._-_.._-_._---_.~ <br /> <br />----..-------.-------.-- ..-------....- <br /> <br />.-------..----.-.---.-------------...-.-..-----.-- <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit Land Total ___ <br />-------- .-------- ____On. ___- _._____...__._______..._____._ <br /> <br /> <br />Recreation ACCOllnt .. _ _ ___ _____..___ __ 1~~CJ:eatir5flT;redit-=~___ Hecreatlon Total ________ <br /> <br />Zone <br /> <br />..-.---.-.--- -_._--~- <br /> <br />TOTAL AMOUNT .L_____________.___.____.__ <br /> <br />Exemrt _ [~IYes [J No <br /> <br />How Determined <br /> <br />-G.-- ___. <br />LIBRARY FEE <br />Land Account <br /> <br />--------_..._-~--_._---~---_.._.~._..._--_.__._. <br /> <br />--- <br /> <br />Facility Accoul1t_________:::=~-FcmmtY-Credlt __________________ Facility Total <br /> <br />Land Credit __ -=---~~==-Land Total ___._______.__ __. ___ <br /> <br />----- - <br /> <br />.--- <br /> <br />Exempt./[..l-Yes--.--!] No <br />~SOURCE FEE ' <br />TOTAl. AMOUNT <br /> <br />'--~_.__._---_._._~ <br /> <br />Ilow Determined Total Amollnt <br /> <br />~-----._-- --~------- <br /> <br />ERU <br /> <br />.-._------"".._--_._-----~. <br /> <br />-.--.-.--..--..--------..-- <br /> <br />..--..._....,_........._"'~.._...,._- <br /> <br />-.-.--""'--..........--.....-....-....- <br /> <br />,~~. <br /> <br />. t.L..,.........______--..__......._ <br /> <br />Prepared By ________ ___________. _._____________ Checked By <br /> <br />---_._._-------_.__._._-_.._-~----~-----_._- <br /> <br />NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPI:CTION <br />PERPORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br />BEEN PAID AND <br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />AclmowledgerJ1ent below does lIot Imply acceptance of concurrence, but simply receipt of a copy of this form, placing <br />the building pennlt owner on notice of this aSStlssrnent and tha conditions of payment for same, <br /> <br />---~..._---_._._- -.-..."..-----.-.-..---,,-----.-.------.-- -----.- <br /> <br />DATE <br /> <br />--RE-CETV~Y ------ ----- -----. <br />fJJiL By4_~___~~__ <br /> <br />RECEIPT NO. ~ l{f~~_L. DATE <br />