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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />~_...._"._,.==':::~~ <br />Permit NO'(~~~55~~ no <br />Date permhiecT a~_~~ <br /> <br />Builder Narne/Owner Name l:;;~ ~tJ;l;"t __ Control # ___,..____.,____ <br /> <br />COL/nty Parcel No. ..__._'_.._____,___ <br /> <br />SubDlv: ~T_~~~_ <br /> <br />Address/Location --_~25 -r:- ~~ ,W~ <br />Classlflcatlon/Type of Use__,_~ ,t= _ D____________________,_____..,______,__,__ <br /> <br />TRANSPORTA1'ION IMPACT FEE <br /> <br />Exempt [] Yes I ~~ <br /> <br />Rate: Sq Ft Unit: <br />_._--_._--~- '--------,'"""-- <br /> <br />How Determined <br /> <br />Impact Fee Amoullt_l---1~ ~ .,[,___ <br /> <br />--_.._--.._,._._~.__...._-----._._~_..._._----_._._,~..--- <br /> <br />Zone No. <br /> <br />TAZ: <br /> <br />---_.._~-_._._-,-- <br /> <br />sel IOOL IMP~ACT FEE' . <br /> <br />-~_.&.- <br /> <br />Account <br /> <br />Exernpt <br /> <br />(066) <br />(057) <br />(058) <br />..t,12~3 ) <br />[,J Yes <br /> <br />Slngle~Farnily Detached HOLlse <br />Mobile Home <br />Other Residential <br />Collec~n Fee <br />[]c.l1o How Detennined <br /> <br />Amount $ --,-,tJ.,6_f~_'_h___..______ <br /> <br />.._-'--~.._----------._._._.--.._-_.. <br /> <br />----------_._-..~,._.__. <br /> <br />'---.-------------.- <br /> <br />-P~ARKS AND RE-CREATION FEE <br />Land Account Land Credit <br /> <br />Recreation Account <br /> <br /> <br />~--_.~-----. <br /> <br />-------. ..---.----. <br /> <br />Recreation Total <br /> <br />Zone <br /> <br />----- <br /> <br />TOTAL AMOUNT "L_,..____________,__,____ <br /> <br />Exempt <br /> <br />How Determined <br /> <br />Ili3RARYFEE'-~-'-------- - <br />Land Account <br /> <br />--..----..-..----.---. _._---_._._.-~--~..- <br /> <br />... .......~---- <br /> <br />.. '----.--...- <br /> <br />Facility ACGOUllt_,__ <br /> <br /> <br />--~.._.--.-.-....._.__. <br /> <br />Land Total <br /> <br />--...-.----..--.--..-.---- <br /> <br />_'___ Facility Total ..,_'_,..________... <br /> <br />How Determined <br /> <br />----------.-- <br /> <br />Total Amount <br /> <br />RESOURCE FEE <br />TOTAL. AMOUNT <br />,\ "-'--, <br />-.:w..~_,,_ ._, <br /> <br />--_.-.._-..~-~--- <br /> <br />ERU <br />~\L\~L\ <br /> <br />....-.-...----~-- <br /> <br />~_M__+___.____...__________ <br /> <br />Prepared By '_'__.____________ Checked By _'___________.._,_________ <br /> <br />NO Gl:FnIFICATE OF OCCUPANCY WILL BE ISSUEn OR FINAL INSPECTION <br />PERFORMED 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 not Imply acceptance of concurrence, bUlslmply receipt of a copy of this form, placing <br />the building permit owner on notice of this assessment and the conditions of payment for same. <br /> <br />--...._------_.._~._-~------------_.--- <br /> <br />DATE <br /> <br />HECEIVED"BY --.--------,---" <br /> <br />RECEIPT NO'-:k:l3-L\~ DATE ~_~BY :s:::L-'u ~~~ __________ <br />