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<br />
<br />J6~
<br />
<br />PASC() COlJNTY, FLOf~IDA
<br />
<br />....-...,"'......- .... -, "...'.,.,.""'......m_....,.._.....7."'~T"'. '''.' ~....~~,...'I",.'-".....'..'........,......,..............,'..OT' ,w'"'''' '........'......"......"-='.., ..........,._.._.......,. ,_,'...... '..~...".,..............,_,.. ~ "',,....__,...,...... _...,...."........<........."'__~.-.-......, ,.,., ,,<.,.,~.......
<br />
<br />Pemllt Nu.
<br />Date Pennltled
<br />Builder Name/Owner Name __ (;2~~\;~{ ~J.t_l('!.1.{(r21'..J~____ ._ Control #
<br />Cnllllly Par(;ell\lo,84.~ d:$.?l-()()I_Q~_,Q~8-~t:)___~a1{._ _ SubUiv:
<br />Addless/l.()(:aflotl _ .;)_. -/:f,t),I.'._ _6::,j( v-:'_'{. -_L5.e.~"._.{t~(_,_._~.._
<br />Classificatlc)/)/ Iype of Use._ Lt~,:, ~)Jk___Lt(.\}J..'-,c..,'___.___"
<br />
<br />~ 1 {, " /'_1
<br />.-', } ti
<br />
<br />-- -7....:_d__:()"-___,
<br />
<br />~_. II.
<br />
<br />TRANspon rATION IMPACT FEE
<br />Exelllpt IJ Yes r-t,] No
<br />
<br />nat.e:
<br />
<br />.-_._-- .,._-----~.-.. --.- - -
<br />
<br />Sq Ft Unit:
<br />
<br />Ilow I.>etemllned
<br />
<br />-----.-....--.. ",,' .-.-...-.---- ,~..-
<br />
<br />Impact I:ee Alllount .JIH=~.~:.~).__.
<br />
<br />/' '
<br />
<br />lone No, TA?:
<br />
<br />....----.----" -'---'-_"'__"__' _n.
<br />
<br />-,-'.,~,- -,.,~"".' " . ,---. -'-,-- '-""-",'-'~' "~".,',, .~ ''''- ,,,,"c.,, .'. ~""""_"'_ '.... .......,".,_,._...."..... "".." .'.._.._".,,,.. '"", __....,'..._~.. ".,.. '''... '...... .. "..
<br />selloo!. IMPACT FEE
<br />
<br />Account
<br />
<br />(USE) )
<br />((Jfj?)
<br />(0513 )
<br />112:3)
<br />r (I Yes
<br />
<br />SIIl~~le~Farnily Detached Ilouse
<br />Mobile "Iorne
<br />Other Residential
<br />Collection Fee
<br />[] No I low Uetennlned
<br />
<br />Alllount
<br />
<br />$
<br />
<br />~"'''---''''-~' .._-.....- ..____ ___n'. _ ..._ ___'_........~.
<br />
<br />EX81 npt
<br />
<br />. -........-..---.---....-.-.... - -
<br />
<br />p"Afi i<SA~i fi'RE(~ REATi6ifFEE" , ., .,..."'~...._,. '~"-'''''"--''-'-'-"''''""" "-..,,.~-_. _~"_...,_.""....."..~__....._..._...____.,,_._.
<br />!Blld I\CCOlltll L.alld Credit Land Total
<br />
<br />. --. "-'''..-..- -.. -...._- ".' .-- -..... .....~.__. ".-.- ...'-.,....
<br />
<br />Recreatioll ACCCllltlt
<br />
<br />necreatloll Credit
<br />
<br />n.ecreatiot] 'rotal
<br />
<br />2'0118
<br />
<br />TOTAL AMOUNT
<br />
<br />, .t___..
<br />
<br />Exelllpt
<br />
<br />I Yes 1-] No
<br />
<br />Ilow Determlne(l
<br />
<br />',~.-,... ...', '........'''...,,~-''"....'............... '_'~"'".- d'.., W'"'' _,._._.... ._ ....~.._.....,.._"..."......., .,...".
<br />UBR^RY FFE
<br />Land I\CCUlIIll Land Credit
<br />
<br />........"..,.,.,,''''~........,..,
<br />
<br />~-_._. - '--~.-. ._--'-_.~-.. _. -____n_. "M__..__.
<br />
<br />Land Tolal
<br />
<br />Facility ACCOllllt Facility Credit 'u_._._....___ _. __'._ Facility Total
<br />
<br />. '.~- "---. --. ~ _ u ._.._._____.._...
<br />
<br />Exempt II Yes [./ No
<br />
<br />---. ..-----.., .. _ 4._...__.___ ~
<br />
<br />How Uelennlned Total Amount
<br />
<br />..-----. __._....._4...., ..~_u_.._ -"__'__'..n,..","
<br />
<br />...~-..- '...". < .,~_....._-,-.'._" .,----.-_~n....,." '."'",.,._".. '>'.... ... '"~....~.....~...,...."'"_..__"''''....,,''_~_..._<~.._'''_,_~..._._"' ....,"",.~_~_.." ..,.""_".._,~
<br />
<br />RESourWE FEE
<br />TeIIN. AMOUNT
<br />
<br />ERU
<br />
<br />. .... _....._-~-.._._---...__._-_..~......_---
<br />
<br />. -...._,,-.~._-- .-. ...~----~_._.._.._.-.._-.- -.-.-..--........
<br />
<br />,.., ., .,." ....-, ..~. .. -, '" ~ ,
<br />
<br />Plel l8ler! ny
<br />
<br />." "-,"',,,. "',' .. "'" "~'," ..,...'... ".. "" ,..." """" "U"'_ " ,",_ ...... ... "... .. ..".. '.. "'''''''''' ...~, '.- '" '... _.',...' "'......,...... ._ _ .,,,... .... ....,"'.."
<br />
<br />Checked By
<br />
<br />.-..-._.--~.. _n _'_"_"", __
<br />
<br />NO GI:HTIFIGATE OF OCCUPANCY WILL BI~ ISSUED OH I":INAL INSPECTION
<br />PEru:CmMEU UNTIL TilE TOTAL AMOUNTS LISTED IIAVE
<br />BEEN PAID AND
<br />I~ECF.IPTl=D FOR BY A CENTRAL PERMITTIN<3 OFFICE OF PASCO COUNTY
<br />
<br />AcknowlfJdgAllIflll1 below does flul Imply aCCfJptcHlr:e of conr:ulrence, !JIll simply I Ar:elpl of a r:opy of Illls form, plar:hl[J
<br />Iho lJulldlng pel/IIII owner Oil notice of Ihls 8ssessIllent and tile condillons of paYll18111 for same,
<br />
<br />DAIl:
<br />
<br />.. .. --....- ..----..-...-..- "-_.
<br />
<br />~-_.__...._-_._--------- .. ..--.--.- - ... ---....-...-----. ....-
<br />
<br />nECEIVED BY
<br />
<br />HECEIPT I.J{),
<br />
<br />. - -. ---. .- --..-...-....-- -..-...
<br />
<br />DATE
<br />
<br />'--~...._--~"- ---...-__.__u__
<br />
<br />BY
<br />
<br />.-..._~. "'-'~"---'"" .....-..--...- - . --._..._..4..._'..__...._...._._._...~
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