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<br /> <br /> <br />PASCO COUNTY~ FLORIDA <br /> <br />--~..........-._~-~ <br /> <br />Perrnit No, .,-._2,3.,L'il~_____ <br />Date Pennllled -S I! - tJ:'5~ , , <br />W~r Nome/Own. r N am" ___ y 11tH j "f! _ /1 t!) '~h Control # ~~~~ _ ~_------'---,-._ <br />ounty Poreel No 3 tj--U;;).J~ O_Q!Q~DO~'l_ SubDiv: >>("~-14.L~ <br />Address/Location _ ,~.~2, Z_~Yt. j~!.~,:L_II(I.8 ( ! {~_~..5::_.._,_____~.._____..., __..__~____ <br /> <br /> <br />Classification/Type of Use_..__,_~, __,._ <br /> <br />.. .n_ _.."--"--.-_._..._~.___....,..~_____._~.__.._..._..~._n'__'__n....__.____.. <br /> <br />-.--_"__. __n____"__. _.___~_,'"___ <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Exempt [I Y bb []/No <br /> <br />_.._._--"-._---_._~- <br /> <br /> <br />Hate: '..__________.__ Sq Ft Urlit: <br /> <br />Ilow Determined <br /> <br />Inipacl Fee ArnoLJnt ..,'~._~_____" <br /> <br />--+_.__..---P-----_._~~_._."-_.._- .._ __ .. .__....._._..__.."._,__~,~_____ <br /> <br />Zone No, TAZ: <br /> <br />--.--.---.--.....-- <br /> <br />SCHOOL IMPACT FEE~--'._._-_.__. <br />Account (056) Single-Family Detached I.jouse <br />(057) Mobile Horne <br />(058) Other Residential <br />('12~) Collection fee <br />EXBrnpt [Q~/t:;~ [J No How DetBrrnined <br /> <br />.......-......-------~ <br /> <br />Amount $ <br /> <br />--.-... -.... ...._-..-.- .,.- ----. <br /> <br />.'--...---.-.-- "' -_._._~-----_.,.-.- -'...----.-- <br /> <br />PARKS ANDRECREATfoN FEE <br />Land ACCollnt Land Credit <br /> <br />~---_._-----_._--~.._.__.._- --- _.~-----~._._-.-.. .-.---.-......-- <br /> <br />Land Total <br /> <br />ReCI6ation ACCOllrlt <br /> <br />Hecreatio[L.GfffclH-- Hecreation Total <br />~-_._--_.._.,._.__._- -.----- --'--"~_. _._---~-_. ------.-.- <br /> <br />lOl16 <br /> <br />TOTAL AMOUNT .~____ ".......______.....___.__ <br /> <br />EXBlllp! r~~:j\;es [] No <br /> <br />How Determined <br /> <br />-'-,..,._-,._--...~--- --"--_._~-.,_.. --_.._.._'~..._._--_._..._~---_.._,_.._...__._------ <br />LIBRARY FEE <br />Land ACCOlllI1 <br /> <br />- --'-'--'.'__...n______ "'_'_h.___._. __"~..., . _ "~'__'_" 'h__ ___ ._"_____..__..._.._~._._..,_. <br /> <br />Lcllid Credit <br /> <br />......----.L:arWfTotal <br />--~:.-=~~-----_., - <br /> <br />F aGility AccoUllt <br /> <br />.-- ,_,,_.:;",_=~=,'facilrtY"C~rec.iit ....'----__.m___ n_.__ Facility Total <br /> <br />_.._ .--_0._____--.'.-.-..--.-..- <br /> <br />Exempt L_J Yes [] No <br /> <br />.--. . ".-. -" _ _.ft...________ <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />-----'--.-..~--'..---~-71..-- <br /> <br />~(~~~IU:~~l~~~ I() ,51 <br /> <br />.,..__.~-~~_.. ----.-------- ...~_.__.~..__.~. <br /> <br />-----.---- <br /> <br />.---.....~ <br /> <br />. ERU---- <br /> <br />a~_1 J....., <br /> <br />- -~_...._-,._--_...._----_.~----- <br /> <br />....-- ~....-.............-....-..--._~~.- ~...................-_- ~...~._~--,....-...........--_......._- <br /> <br />-_._----...--~....- <br /> <br />Prepared By . ...n._________n.____________________._ Checked By <br /> <br />----".-----__._.___..n___ ._...._.. _ "'_.~.________ <br /> <br />NO CERTIFICATe OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />PEH:FORMED UNTIL THE TOTAL AMOUNTS LISTeD HAVE <br />BEEN PAID AND <br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />Aclmowlbdgernent bt:llow dOBS not Imply Clcceptance of COllcurrence, but simply receipt of a copy of Il1ls form, placlnu <br />the building permit owner on nollc8 of tlils assessmbnt and the conditions of paYllltlllt fur same, <br /> <br />_"n _. -- - ~_.. _'.. ____+__ _.___ .-~u__u_'..__._u. ._______ <br /> <br />DATE <br />RECE IPT NO, (o(/!jl~/1:) DAlE LDa?J.!!~ <br /> <br /> <br />/ <br />