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<br />
<br />PASCO COUNTY, FLORIDA
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<br />-~"._""-"".._,..~..~~-~"'..._._'-~.~.._-~--~---_._--,~..."_.._-'--_._,,..._,,-.~--
<br />
<br />I _1
<br />Permit I\Jn. . -~;{;;2Js/'f?__.
<br />Date Permitled .--2"-/.7d~()_:3
<br />Builder N"llIe/Owner Name LkLi~1titL_C_{~Cl:;._.__ Control # ._..._._._. __.___
<br />,.,) . - ~.~.
<br />CUlln I y P al<;elll (). t!L-;;L L :?L--l2c2f).Q.::.ilQLJ'2f2_~'<2.4.'lt)_ S 1I bD I v: (~ t...cY"'"_
<br />(/
<br />Ad d res s/I.o,," 110 n --1"-'i'2.ff'_I2",,:m k,J4j;'___ _ __ ___ . __ :::::c:- _ _ ____ _. ___ ___ ___
<br />ClasstflGatlon/ rype of Use _ :::.j_......,_~__L/t _f2-g"W'1{~__Lkte~<.
<br />TRANSPORTATION IMP ACT PEl: -.- Rate: J-!. __ Sq FI UnIIC~'__ _ _. _ _ _____
<br />EXelllpt [J Yes "K~(j\Jo Ilow Determined
<br />
<br />Impact h:~e Amount _~_,,_____
<br />
<br />--- --,.._-"'-~.-...__.-.. ..- ....-
<br />
<br />Zone No,
<br />
<br />:cfCJ 1001.. IMPACT .FEE
<br />
<br />~'----"-._--------~
<br />
<br />TAZ:
<br />
<br />..............,........._'-~...~---.............~
<br />
<br />~~-.........~,.....'"'--
<br />
<br />......->................--"'.-....._"""-~_........._.,......._..-...........>,f
<br />
<br />I\cc;ount
<br />
<br />(056)
<br />(057)
<br />(058)
<br />{'12J)
<br />1_ ) Yes
<br />
<br />Single-Farnily Detached House
<br />Mobile Home
<br />()lher Residential
<br />Coll~tion Fee
<br />\lNo How Oetennined
<br />
<br />Amount
<br />
<br />$
<br />
<br />~"-"<--'- -.., '. '"-- ~.. "".---.--, '- -'.~-
<br />
<br />-----.--..-__ "n. "___ .__ ..__.__.
<br />
<br />Exernpt
<br />
<br />pARKS AND REC"REA TION FEE ...-...--------~___.._
<br />Land Accolllll Land Credit Land Total
<br />
<br />-------
<br />
<br />-----_.._.~._-.
<br />
<br />F<ecreation !\CCOlHll
<br />
<br />--~----.- -._- ", -" ... "..-.-------.--.
<br />
<br />- ..--.....---.----- .-.-..".
<br />
<br />F<ecreation Credit
<br />
<br />r~ecreatjon Total
<br />
<br />ZWI8
<br />
<br />Exernpt r-J Yes [] No
<br />
<br />TOTAL AMOUNT .-L~_"
<br />
<br />Ilow Detennlned
<br />
<br />_._,._---'_._---~....~._"~,,..,_.~~..,,_..,.. _...__...._,.__._~.._--_.. ._.._..._~..._.._-~--~~..._.._--_.__.^'_._.-.._-~._"..._-~
<br />
<br />LIBRARY FEE
<br />Land !\ccount Land Credit Land Total
<br />
<br />.. ------~..__.__.._... ""-.....-... .-----------..---- ---. '---'--.- -'. .. -.--.. '-'-"--'
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<br />-"-'0_-.. --___~._ . ....._____.____0__.. _.___~._.__..,..___~.__ ___'. _..___.___~
<br />
<br />Facility ACCOllllt
<br />
<br />'-_~H~_____,,_ Facility Credit
<br />
<br />_... -.----.---...---.--..
<br />
<br />Facility Total
<br />
<br />Exempt [-j Yes IJ No
<br />
<br />Ilow ()etennined
<br />
<br />Total Amount
<br />
<br />RESOURCE FEE..-q----...-~:------~.~~~.----~"._._, ERU.-~-..-".------.._..-.--~
<br />-. .' . - "J'
<br />-I c.-.rr-At., AMC,_')lJN"j' . i' : \
<br />.-.--'_'___..J___. . _'__ '___n__ ____.-...:...____.
<br />
<br />--------.--. - . ._-_._--~---~
<br />
<br />.-~._-----..__..-...- -----...---
<br />
<br />........~ ~.............."'._._...o.-....... _'.'.~.............................................. ___.....
<br />
<br />"', -----------""--._--""--..............""..:...---..............._..............~ '......--.............--".
<br />
<br />-~..._-...-
<br />
<br />Prepared By _ -h____._____h~_,,___. ________~_______~___ Checked By
<br />
<br />._.._-~.~ --------. -...-_.-~.~._-_... _..... -.------.-0-..- __0__.. ._.
<br />
<br />NO GEHTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
<br />~)ERt::O.~Ml:D UNTIL lHE TOTAL AMOUNTS L1s'n:D HAVE
<br />BEEN PAID AND
<br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
<br />
<br />AGknowledg8ment below does not Imply acceptance of concurrence, but simply receipt of a copy of this form, placing
<br />the building petlnlt owner on notice of this assessment and the conditions of paYl1lent for same.
<br />
<br />DATE
<br />
<br />.. _._~--_.---- --..... -----......-.-.-----
<br />
<br />RECEIPT t.JO.
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<br />l .,'~ ;1 i. ;
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<br />-- --'--'-'--'-'-----,-.--. -..-.-..----.-. .--- -----------.---...
<br />
<br />r~EcEIVED BY
<br />
<br />Ii.
<br />.------.---..-.-- --
<br />
<br />DATE: . J
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<br />, ..
<br />, .J
<br />
<br />BY
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<br />--.__.._--~--'-.._~._. ---
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<br />~-.-' - ----.- -.-- .---...---.-.-...--. .--.--~-..-.._._...n~~_.._
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