|
<br />
<br />PASCO COUNTY, FLORIDA
<br />
<br />Permit Nn, --...__e?f2..2~_...
<br />Date Pennllled _.i~:::./-.':1.,=_.t2~
<br />
<br />Builder Name/Owner Nanie _JJ ~___~__ Control # ____.____ _.___
<br />
<br />COllnty Parcell\jo. 3,Y-:~~J:::"OO LO..:::",O 0 YO _____._ SubDlv: .__'..'....,_.._.___,_.____,.
<br />
<br />Address/Location -.-3~L~~::t--~ ~_.__6_~< --~----~.-----_________h,___
<br />
<br />Classlflcatlc1I1/Type of Use
<br />
<br />'_..._--_..._~.._._~--_._~_.._-_.~------._~.__._---- .--"---..-.-.- -_. --.------- ._-~~-_.---
<br />
<br />TRANSPORTATION IMPACT f:EE Hate:
<br />Exernpt 1-,] Yes l ~~ '.Iow Determined
<br />
<br />Sq Ft Unit:
<br />
<br />--.------.----..--..-....,.---.- - ..'---.--,.---- --
<br />
<br />Impacl Fee Alllollnt__t__1._5_~..[___ __
<br />. f
<br />~ t...........~~................... .---..~.,.--..-,.._-...............~-..."'..............-.............".~....."'...""".........'''''......L'~....'_..................,_,""..."'.-........,...........,,l.~_,...
<br />'sci10C)CiMPACT FEE'''.... .. -
<br />Acuount (066) Single-Family Detached HOllse Arnollnt n; ___._.___..____ "______..___
<br />(057) Mobile Home ._.__.__.______.,., ..___ _
<br />(05B) Olher Hesldentlal _ ____ __ . __ _ __ _ '_... __ _
<br />Exempt [~(tle~~on F~~ow Deten nlned __._ ___. ___ __. _ ._____. _ _ ___ __ _.___.
<br />
<br />Zone No.
<br />
<br />TAl:
<br />
<br />P'ARi<s ANf)" RECREA:rION FEE >-">..~~-'-_.---_._.,-~=~~._>->>-.-,--,--"~-.,."'-...".~_M.,----.~..
<br />Land Account Land Credit -AfJTotal
<br />
<br />F~e(:1 eatlon I\CCOllllt
<br />
<br />
<br />--~---_.~-_... ......- -_.,~.".-..~-...._,,_.--_.
<br />
<br />._.~
<br />~...-
<br />--~~____n__.
<br />.~ [OJ Yes [] No How Determined ---'--.--------..--,-,_______h___ _____.._____....,.......
<br />
<br />
<br />t'j'B'RARYFEir'..'-~.--......,.,-.._-~.~--.u~-.~-...-.--..~~.._._---'"._.~._~-.-.-~.-.-..,.,_..___._.._.,,_._.
<br />
<br />
<br />Land l\cccl\\lll Land Credit _.-----kalld Total
<br />.. "..-- ....-.---.-----... ----~_--n....__ ._____..._.._.._.___...__.__. _.______
<br />--
<br />--
<br />Fadllt)1 ACUOlllll__ ,__~~._-:=-1~aciiftY(:redit ___.____.__.....__._ Facility Total '__..___._,..____..
<br />.-----
<br />E)(elllpt/~+]y;s [] No
<br />,/'"
<br />RESOm~CE FEE..'~...------.._-..~-~ " \)I ~-.-~-~ERU-~~~=_____=~~~.~=~===-==_~
<br />'1'()'!'At, AMOUNT ..---..---------1....J..::!.__~
<br />
<br />Recreation Tolal
<br />
<br />ZOl18
<br />
<br />TOTAL AMOUNT
<br />
<br />" $--.,-..-..--------,.., '-""-- ,.. ---.-.--
<br />
<br />Ilow Determined
<br />
<br />Total Amollllt
<br />
<br />---'__""_','_n_. _n____~__
<br />
<br />...._,.. ""." .'.... ............. ......~..... ~.n."'......'-'....'""..,__"'-"........... "'._~...............,................._".... ,.........-....-....u......._~.-.........._ .
<br />
<br />~..........................~..__-........,_...."~......----.........--_...'-..-
<br />
<br />Prepared By --.------..-'_____'_h__,___,______.__ Checked By ____..___._____..,_.__ __ ._
<br />-- ....~---_.-
<br />
<br />NO CERflFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
<br />1:)1:1~I::OJ~IVlED UNTIL THE TOTAL AMOUNTS LISTED HAVE:
<br />BEeN PAID AND
<br />RECEIPTED FOR BY A -ceNTRAL PERMITTING OFFICE OF PASCO COUNTY
<br />
<br />Acl\l\owledgemsnt below does Ilot Imply acceptance of concurrence, but simply receIpt of a GOpy of Ihls form, plac\n(J
<br />the building permit owner on notice of this assessment and the conditions of paYl1lenl for S8me.
<br />
<br />--'~~--.~,--.-.----.- .,~-~..- ... .. ---.-----.. ____'-.__h.__..__~.___
<br />
<br />DATE
<br />RECEIPr NO, (.QliO~_~DATE
<br />
<br />--nECEIVE[5 'BY -- .----- --------..,
<br />
<br />) '\ -~ ''QOY
<br />w.-_d.-.________.. '~_.._.w
<br />
<br />_~~h ~
<br />-N '(J~~I,~-...-
<br />
|