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<br />
<br />PASCO COUNTY~ FLORIDA
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<br />-"'"'----....-
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<br />./ J' ('I / J
<br />Builder ~JClme/Owner Name _.}:'.ll""~(~f1fl~r'!.\ Control '#
<br />County Parcel No. _ll{:-l;;!_,;GI.:_.P ~L~,:,P /3"__,___ SubDiv:
<br />
<br />Permit No. ;?c:./~ V
<br />P-'-"--'---'_h_C,.J_,_._~. ,..__.__~.____.
<br />Date Permitted ..,_Lf-" :.:.]Lp l..._
<br />
<br />--.---._....___ .'u... .__._.___"_~
<br />
<br />Addres:s/locCltion . < 'J---;) (> 1-0 h!/J w.... I-:)~/e-
<br />-----'.-'..------'-----.-------.----...-------------------,----_._._--'---,--,--
<br />
<br />(iA /J 1/...'
<br />- /' )'i.'" L(/ 1'1'" J..:'C:/)'-J
<br />--~--_..----'--._-_._._().---_._-
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<br />Classiflcallnnnype of Use_ _'l'hQ/.!~j'Q _~~____ _________ _ ________ _ ______
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<br />TRANSPORTATION IMPACT FEE
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<br />Rate: _____'__________ Sq Ft Unit:
<br />
<br />Exempt
<br />
<br />l-----j Yes [--I/No
<br />'-- LJ
<br />
<br />-~----.- .---..-----.--... --._---.~-.-
<br />
<br />How Detbrrnined
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<br />Impact FtJb Arnol/nt,Jh,___t.S~~b:/_.,._,
<br />
<br />----...-. .---.----.,.---..,.-....-~----'__h___. .__",_ .. ._n _._.____._.__.__ _.. ... ___..".__._.__
<br />
<br />SClfuOL IMPACfFEE
<br />Account (Cl56) Single-Family Detached House
<br />(OB?) Mobile Home
<br />(OBB) Other Residential
<br />J.:IJ{:l) Collection Fe~
<br />Exernpt !LA Yes rJ No How Determined
<br />
<br />Zone No. TAZ:
<br />
<br />-'--'--'-'--'--.--
<br />
<br />-------~~
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<br />...-. '.-.. ._--._.._-~~--.._..,.-
<br />
<br />Alllount
<br />
<br />$
<br />
<br />~-~___h' ',____~._ ___.._. "._.._
<br />
<br />~._~_._-~._-,.._.-._----- _._.-".~...,~.".~.__. "..---
<br />
<br />------'....--,---.--.---.--.--...-- -. '-'.--...,--.-- -..-
<br />
<br />----.------..'----.--.--.-.....----..----- -_....-._---~.~.,.-.._.._- ..-..--.... -..
<br />
<br />PARKS AND RECREATION FEE -~------
<br />Land Account Land Credit
<br />
<br />-~ ~
<br />
<br />---
<br />
<br />Recreation ACColmt
<br />
<br />---:::::;::;.0--
<br />
<br />.LaAd'T6tal
<br />
<br />Biilere'affon Credit
<br />
<br />--------.-.- .'..--.--..-...-------.--
<br />
<br />Zonb
<br />
<br />------------..._,-
<br />
<br />I~ecreatlon Total
<br />
<br />----.._--~_._-_.-
<br />
<br />. ~-.~---_._-.._-_.>,.-~--
<br />
<br />TOTAL AMOUNT --L___....__._,_,____,...
<br />
<br />Exernpt [] Yes [] No
<br />
<br />Ilow DetermillE:ld
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<br />IIB'ffARY FEE-'--.--.,-'-------.--"------~-----"_______.
<br />Land Accuunt .._"._____ Land Credit _____'_~_______
<br />
<br />.-----
<br />
<br />---....-------- ---- .....-----.....,._,-- '-"---~ -..-- ...-- .-..._~-
<br />
<br />..-----
<br />------
<br />
<br />- Land Total
<br />
<br />Facility AGGntllll_ ---:.c=----"--.PaellltYCredll _________.____ ___ F aGility Total ..___ ______________
<br />
<br />__ no "'_"''''_'__, _'_._.._. .__.__..__.._
<br />
<br />Exemj2L{] Ves
<br />
<br />I] No
<br />I d c1!J ) l II (j-ir;) r:--:. I
<br />
<br />. --ft'-:"-'hH_______'_h___..,J
<br />
<br />How Determined
<br />
<br />RESOURCE FEE~
<br />TOTAL AMOUNT
<br />
<br />------------.--,..
<br />
<br />Total Amount
<br />
<br />--.- --~.-------,- ---
<br />
<br />--- ERU-~--------
<br />
<br />_..~-- --_.,----"--_..,.,-_._.~ ----_..._...-._~,~._"
<br />
<br />.....,--_......._....-....-_'~.._...,~...--~..._..~.........._-~---..._,....
<br />
<br />~--....-_------~._---
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<br />PrepQre(j By .. ...__'______'__..,______________ Checked By
<br />
<br />---_._-_._.~_._----_.__.~,._.~..._--~~. --'-----
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<br />NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
<br />PER~ORlVJElJ UN"flt THE 'rO"rAL AMOlJN'fS US'fl:D HAVE
<br />BEeN PAID AND
<br />REGl:IPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
<br />
<br />A"lmowl'dge",enll,elow doa. "01 Imply acc'ptance 0' concnrrence, bnl simply recelpl of a copy III till, lonn, placing
<br />the buildinu pennli OwnElr on nollc8 of this asseSSfntmt and thf.l conditions of paYlllf:lnt fur same,
<br />
<br />--.---'----.--..-.---,.-.......-.-----..-.,-.. -- ------.--.. ..-----.--
<br />
<br />DATE
<br />RECEIPT NO.C(i..1~!jJ(':)_ DAlE
<br />
<br />-,drJ'-i ByR~':~~~{ ,,4_7).-- . .
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