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<br />
<br />PASCO COlJNl'Y~ FLORIDA
<br />
<br />.. .."-_....~'u,.._,~ ... "......~..~L~.n.'_..... '_"...'..v_.",..'. '''....,,,........-'.~..,_.,......._''-t..n..,~_~.....,,.. .. ......""_....~_..;~n.....' .;;.;..., ,~, ..... .",.... ..'"'-,......., I.__-,.._~..... '._, ~ _...
<br />
<br />~...."'''-,~..........._'.,. "~""..........~.,.".. . ".."....." .,~
<br />
<br />/'1 /1 1/.. '
<br />Builder l-Ia1118/( IWI lei t,larnEl k-,\:;t./~{c..tf""-~3&-'~ 1:_1.______
<br />(;Ultllty Pal(;81IJ(), ~3 ,)~.;J_;";'" J I_~_~~_l O_=~_~,I.'~CI
<br />Addl ess/l()( ; i:1I icli I ~} ?~/O_. !\J.1!< (..k!-(J~)_). li!::/C~___.
<br />Classific;allul\l Ivpe of Use jh,(;l--:....~<~ __!:{t)(!,-~-:-::
<br />
<br />, '7" > /"1
<br />Pel I lilt I"lll, ._._e~ 1.1__.__
<br />Date Pennllled -.iI':-3:~ c': ~._
<br />
<br />(;ontrol #
<br />Sill )l.llv:Et~t1( <~}jl"Z:j4-h /J,tf;O
<br />
<br />'IH/\N8PORIAlIUN IMPACT Fl:E
<br />
<br />Hale:
<br />
<br />Sq Ft UlIlt:
<br />
<br />['':XBIIII)1 I . I Yes IIJ1'lo
<br />
<br />Ilow UetBl"lrIll1ed
<br />
<br />Ilnpad Fee AIIIO/llit ~...-~.jjf\r' _~'c,
<br />
<br />lone I'Jo,
<br />
<br />TA?:
<br />
<br />"sel i()()i,~iM p-A(~f"FF. E"" "'-~~'" "'--'.-. .... .. -.-"'~" ......- ..----.
<br />AC(;Ollllt (0511) Blnole-Farnily natadled Ilouse
<br />(OR"/) Mobile 1I0ln8
<br />(05B) Other Resldslltlal
<br />{'I 2) ) Cc:l1ec:tlun ree
<br />E)(elllpl I (-Viles [_I No Ilow Detennlned
<br />
<br />~ "''''~'.'''"'''"~''q....._....,... ~~;I...,~-
<br />
<br />- ,.... .... '>,. ,~. ..... ... ,'...n'
<br />
<br />J\1l101 II It l\l
<br />
<br />"PAR 1(8 AH Ii F~ECR EATi6iTf. EFT" ...._,-.,., '-~'.. _..-''''--,..-'~::~,.. -,
<br />Lalld Accollllt l.and Credll Land Total
<br />
<br />".-.. .. ...............,... .. .~.,~'. ... -~_..,.
<br />
<br />l~e(;1 Hell illll Ar;(;Ullllt
<br />
<br />-r~ecreatloll Credit
<br />
<br />r~ecreatloll Tolal
<br />
<br />lOllS
<br />
<br />u ;_:.-.;,;.~.-'.<:...-
<br />
<br />rurAL AMOlll\Jl
<br />
<br />~-
<br />
<br />EX8~!Jf1r/'~1 I YSo '"]I'Jo
<br />
<br />Ilow Determined
<br />
<br />'Li'BRA~RY FEE"
<br />Land )\C(;(jllnl
<br />
<br />, . ......-. ~_'._'.L......-._" .....". . ...,c. ...... ........._. ...., u, h..."'..... ....,..~.._..'~_'.~. .", '_ ~ _.'.....~__L.'
<br />
<br />"......"-...,, ............,."
<br />
<br />Land (~redit
<br />
<br />Lal)( llotal
<br />
<br />FacllIly jl,CC()1II II
<br />
<br />~.::O-.,----. l;aclllty Credit
<br />
<br />Faclllty Total
<br />
<br />Exellll!.L/-f 'j'ies 1.1 No
<br />
<br />RES6UiicE'F'Efe "~''''
<br />TUlf\l. j~IV1()lJt'n
<br />
<br />Ilow Uelem lined
<br />
<br />Total AmulIllt
<br />
<br />,-- .--.-,...."'.-...., .-~"'.-."..,_.,-~---"~,......,.",._,- '.-".. -'-'.'-". f~RU' '--"'" -...-,...... .-....,.. '".....'"_.,....,.,...,_._-,~
<br />
<br />. .-.- -.._ __. ___no _. __.__. _. __", .___.. ___
<br />
<br />",. -....., , ,,"- -." '<.,. -'..-- "'- " - c.'. \ -~, ".., -'_"'.,..,.~.. n'_'" .....,....._ .. .,_,,, _., ..._, ."..~........,._. '... ..".. c~. ...~~...~
<br />
<br />Prel lal8d Hy
<br />
<br />Checked By
<br />
<br />NO GElfflFIGATE OF OCCUPJ\NCY WILL. 81: ISSUED OH FINAL INSPECTION
<br />IlEHFcOJHlVlEl> UNllL 'filE TOTAL AMOUNlS Lls'fED HAVE
<br />BEl~N PAID ANn
<br />HECI:IPTI:n FOR BY A CH:NTRAL PERMITTING OFFICE Of PASCO COUNTY
<br />
<br />,A,cl\l\Uwlt:H!gelllfJnl iJbluw does Ilot Illlply acceplance of COIIClIIlSnCE:l, hut simply receipt of a copy of tllll:3 forlll, 1>18clno
<br />lilt! tlllildlnu pelllllt OWllsr Oil IIotlc8 of this aSS8SSll1bl1t Ellld the cOllditlolls of paYlil611t fOI 68mB,
<br />
<br />DATE
<br />
<br />I:~ f: rrfl\ifh, l3Y ---
<br />JIlL,tl)", IW fjr- J.<r~ltL
<br />
<br />f~!:CEIPT fKl, Ce_j=IIJ{~; nAIE
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