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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />....."""""""'-+o______.................~,......._. <br /> <br />..........-- <br /> <br />....---------..---- <br /> <br />Permit No, --,2 .2 ~,21_________ <br />Date Permitted --Lli..J2l___ <br />Builder Name/Owner Name _. -~~"IQ Ib 4~, Control # '__n.~_ <br />Counly Pamel No.3/J '~:=:AL" "0 J.Q::.CJ "'/7 DAl'--7~uIfIV: -QI':'g""Jt4~.-,," } ~...s <br />Ad(1 res s/I.ocation ,___ __':>2_7 -f...~.L--tJ!:-~-llfli:lz.PAJ2.llLd~_____________ _,____ ..____________.___ <br />Classification/Type of Use 11d_t!}!~1~-, ,_/d:..e ""(_ '€- ________________________________________ <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Exempt [] Yes [JiJo How Determined _______________________________________ <br />Impact Fee Amount ..-~--------jL~Lg()..._:/: Zone No, __.____ TAZ: --___h__ <br /> <br />Hate: __________ Sq Ft Unit: _________________ <br /> <br />- .----........---.. ._~---......... <br />SCIIOOL IMPACT FEE <br />Account (056) Single-Family Detached HOllse <br />(057) Mobile Horne <br />(058) Other Residential <br />LiP) Cgllectlon Fee <br />Exempt I dYes !_l No How Determined <br /> <br />PAR.<S AND'RECREATION FEE "- <br />L.and ACCollnt Land Credit <br /> <br />Amount $ <br /> <br />--------..., -~-------_.,----.,.-.._._-_....__..._--- <br /> <br />-----'--_....~-~---,_.__._---~._.- <br /> <br />-._-_.._---.----~_._..__.._-- <br /> <br />._--_._-----_...._-_._-_._------~--_..__._._---- <br /> <br />"..~ <br /> <br />Land Tolal <br /> <br />---.---.--. .-.~.._-._._------ <br /> <br />Recreation Account I~ecreatlon Credit Hecreatloll Total <br /> <br />-.----.- ----- -...-.._______ u_.__ _.~ ..____ <br /> <br />Zone <br /> <br />-.--..-...----.---.--.-- -~---~---_.... ---. --------.-,--.--- <br /> <br />Exernpt [~] Yes - [] No <br /> <br />TOTAL AMOUNT ,J____ ________________ _____ <br /> <br />How Determined <br /> <br />ITBRARY FEE~--.-~_.---,.--~,-~--..--,-.~, <br />Land ACcClunl LarKl Credit <br /> <br />---..~--~---. ------.---------.---..-----------. .-.~--..._- <br /> <br />, ...._~..............---......- <br /> <br />-----------~-_._-- <br /> <br />Land Total <br /> <br />Facility AccOlJllt <br /> <br />----.....--.-.--..---. -~. --'-.'-'-'-,,-. <br /> <br />'. __ __________~ FaCility Credit <br /> <br />-.. --.--.---.-.-----.--.....--- <br /> <br />Facility Total <br /> <br />Exempt [J Yes [] No <br /> <br />RES01TRCEFee---~ <br />TerrAL AMOUNT <br /> <br />"'~'_.~-- --.-..-.----.---- <br /> <br />How Determined Total Amount <br /> <br />--------...--- ----.-..-.,.----- <br /> <br />ERU <br /> <br />......--......- <br /> <br />.-------.. ---_._----~--_._--_.__. <br /> <br />~-----_.__.._._....._---_.._._- ------ <br /> <br />....................._.""""-........_"~._.......,~;.....~~~.,-_. <br /> <br />.....--............................... <br /> <br />~-~..........._~- <br /> <br />....---- <br /> <br />Prepared 8y ________._______________________________ Checked By <br /> <br />--- .-. ------.---~-.-.--....__.._..u ~____.________..._._ <br /> <br />NO CernlFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />l)ERrOr~MED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br />BEEN PAID AND <br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />Acknowledgement below does lIot Imply acceptance of concurrence, but simply receipt of a GOpy of Ihls form, placing <br />lhe bUilding permit owner on notice of this assessment and the cond/llons of payment for same, <br /> <br />-.----.-....--.-- -.-.- - .-.---.--..--------.---- ---.-.-.--.-....----- <br /> <br />DATE <br />RECEIPT NO. ~_tJ!!(j[J~ DATE <br /> <br />id/ --RE-CEIYE--~ Y,7 ---'-------------- <br />?( . - - <br />----J~_l_ BY _______________________ <br /> <br />