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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />--..........---..- - <br /> <br />---.---- <br /> <br />. , <br /> <br />Builder "'arne/Owner "'ama -_f~_It~ ____ ~~r~f /I ___._____._ _____ <br />COllllly P8I'cBII'Jo, ..Q'1.-:2.S-:-..._CJ./=-Q.flLO...... O~&OO.: SubUlv: __...____________________.. <br />Address/Location ---,p7i?!:!-:J.-__~~____..Ai e . ____.._.._.____.._....____________.__ <br />Classiflcatloll/Type of Use .-..-..-l!.:w.bJi____J~___....____._______....__ ..... ..________ ._..______ <br /> <br />Permit No. ~ 5:J. 3 <br />Date Pennltie'(J-=7Z.:2.1..~~~= <br /> <br />TRANSPORTATION IMPACT PEE <br /> <br />berl1pt [I Yes [~o <br /> <br />Hate: Sq Ft Unit: <br />-..- -.------------- ---- "'- ._~--_._. ,----.- -.- <br /> <br />Ilow [Jetermlned <br /> <br />Impact Fee Ainount._~________.._....______..____.. <br /> <br />-.--..-., -..-..--- ..---.....-.... '--. -, '.._-_..~--_.- .._-.. ......--..----.-..---.----. ---..--- <br /> <br />Zone No. TAZ: <br /> <br />--------.-- <br /> <br />SCilOOL IMP ACTFEE--.;......-------- <br />Accuullt (056) Single-Family Detached I'louse <br />(057) Mobile Home <br />(058) Other Residential <br />_112>> CQ!leotlon Fee <br />Exell\pt [_~ as fJ No l'low Detennlned <br /> <br />"""'--"-~---.....-_._..... . <br /> <br />-~-..-.. <br /> <br />Amount $ <br /> <br />..------...,...--..-----.-- -,..... "-+_.._-_._~.,-~-- <br /> <br />-----..-~.-..-- ---- -~ -__"_. h_.__~.__ <br /> <br />-----.---..----.--.-.......-----. <br /> <br />P'AR~(S AND R ECREATTO'N FEE .--___N~__ <br />Lalld ACCOllllt Land Credit <br /> <br />.---------- ----.-.---..-..-.--.---.....--.-------.--.-.-- --..-... <br /> <br />---'-'~- -- +-. -..--.....--..-------. <br /> <br />---Land Total <br /> <br />H8CIsatlufl AccUllnt <br /> <br /> <br />-+-----.- .-----.....-..-.-- <br /> <br />Hecreatlon Total <br /> <br />ZUlle _______=~-;~~ <br /> <br />EX8111Ui//[T Yes [] No <br />~ <br />TjB'RARYFEE'--~"-..-..-_._.--_.~------------.~-_._---___._~_._._.__..________ <br /> <br /> <br />Land Ace"",,1 .---. ...._____~::----------- ___ Land Total _.______ __.______ <br />Facility AccolJnt _____ Facility Credit Faolllty Total <br />-.. -.-::.:-:=:"----.---..- --.--.------..---- ..----...-..--.....-...---... <br /> <br /> <br />Exel~__Et'ie; [] "'0 How Delannlned ________ Total AllIolll1t ____________ <br />,...- <br />--.----~.-----.. .J/ ---- -----...-----.-----.~~--.__.---_~ <br /> <br />~;~2Iu~~~1I~~~1JfJt:-}i?:JliN ) ERU .. -m-______m___ <br /> <br />--- -.---- <br /> <br />TOTAL AMOUNT <br /> <br />. .~-_....__._--..-- ...-....--- -..---- -- ------ <br /> <br />Ilow Determined <br /> <br />--'~---_._--..--..-.-._-- ._-. -_._- --~ ,._-~ ---.---- '--~--.-... "'_.. _h_ <br /> <br />'... -'......~....~......_......._..4.~ ....~....................._~...._...._._~____,.........................____......-. <br /> <br />.-.~....--..-.-............---_....Io........____.._________ <br /> <br />Prel lared By __." ..__._......._.___...____.__ ....._________ Checl<ed By ____._.__._____.__._..____...______ <br /> <br />NO CERflFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />PEHPORMED UNTIL TI-1E TOTAL AMOUNTS LlSTl::n HAVe <br />BEl:N PAID AND <br />HECl:IPTED POR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />Acl\l\owledgelnent bCilow does Ilolllllply acceptance of conourrence, but simply reoelpt of a copy of Ihls form, planing <br />tilE:! building permit owner onllollca of this assesslTlent and the conditions of paYl116nl for same. <br /> <br />---'---...-- .-.---. <br /> <br />DATE <br /> <br />.. -TlEC-~;)'lw- :--- ....t. ..-_:~. --- <br /> <br />"\ . ...- ... } .) <br />j.J/!iL BY 7J~Y2iu--.j- .:. ~.".<~ <br /> <br />---.-- _._... -- .-.... ...- ..----.----..--.--.--__..__.h____ <br /> <br />DATE <br /> <br />RECEIPT HO. <br />