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<br />
<br />rJASCO COlJNTY, FLO'~IDA
<br />
<br />.....,.,."" '0;,.,,_", ""~.". ,..............,..,.................-........,"',_ "." ""', ..~..'. """"""':"'''' _n....,...,..,.,.,..'".. "'",."...... . "'~
<br />
<br />.' ..............,...,.."""'-.,. ;r "'" ."........,....".. ....,.-""!......,......~..'"'.,.......... ,-', '""""~~", ....-n~_'...'..,...,..,;1...,.'.... ""-_-<orI' '0"-'" _~"~" '''';''7'''
<br />
<br />Builder Name/Owner Nmne
<br />
<br />j tj //9
<br />Permit No. ,.-...___.'..-2. !~_!_.!-__
<br />Date Permitted _.. '/ '.:d.!.~__{'L'
<br />.. '/'1, ,
<br />("'("1/1((/ !/r'lf./ ['It.J (;ontrol#
<br />_, '_'_u",___" "____._'--___..,________,)_ '___._____ __ '____.....,_,.._
<br />
<br />'" ~ ,,1- 'I [' ,
<br />.j)) I, (I(.:~~_ ('_,)..J"_(_:~:.~_ ...._Y.:.? ~'I.I) )/1/:
<br />
<br />COtlllty l'al'(;E~II'1n.
<br />
<br />~-) ,r / .
<br />..) (
<br />
<br />1/,. ( ,
<br />
<br />TRANSPORTATION IMPACT FEE
<br />
<br />Hate:
<br />
<br />Sq Ft Unit:
<br />
<br />EX8111pl ['J Yes ItJ No
<br />
<br />Ilow Determined
<br />
<br />ImpRct Ff3H Amount $_
<br />
<br />;,) () S
<br />
<br />70n8 No,
<br />
<br />TA?:
<br />
<br />-sciTi)6r:"j'MrAc'T'FEir-"'~-'""'" "... ."..- -"'~'"
<br />
<br />Account
<br />
<br />(USA)
<br />(05'1)
<br />(Of)13)
<br />{tlJ)
<br />11 Yes
<br />
<br />Sill!Jle..Farnily Uetached Ilouse
<br />Mohlle Horne
<br />Other Residential
<br />Collection Fee
<br />1_--1 No Ilow Deten nlned
<br />
<br />AnlO1tnt
<br />
<br />$
<br />
<br />_n _.____....,.. __..." __..____.___..._
<br />
<br />Exempt
<br />
<br />PAfH (3 ",)\H f)' n F:(~REATT(yN...FEiT ..' ..,.....,,----....
<br />LaIHl/\I;<;Olltll L.and C:redit
<br />
<br />Land Total
<br />
<br />r~e(;lp,atil)n ACCCllII1!
<br />
<br />I~e(;lealion Credit
<br />
<br />Hecreation Total
<br />
<br />Z(lIle
<br />
<br />TOTAL AMOUNT
<br />
<br />u2P___ ____
<br />
<br />(
<br />Fxenlpl ,- I Yes [] No
<br />
<br />Ilow [Jetermined
<br />
<br />., '. . '....., ....'" ,....'.........~..._, lo._"",,-, ~._"....... ",
<br />LIBRARY r:F.E
<br />LaIHI/\<;CUIIIII
<br />
<br />_.._.._--_._~-_. ....- ----'--""- .----......-.-.-..--.....---.-... '-'---'----'-"
<br />
<br />. -,'Le. .." '.'.' ~ j',- ,- h_'",,, ,--",...~ -." .".,., -,...' ..,,,...~. ,"'.,~, "',' " ''"'''''~",.,,.,, u........".,...... .,........~ '. ,., '.'~" ,..'........=. . " "'-'~. .,,~, _. ""_'''~.<'~ _...... '~"'''_''''''''''''~~' .."...,.-,."'""'....,...,..,-...,<t-._.~". ~~_".......~~.
<br />
<br />LAnd Credit
<br />
<br />--........- ---- - --'--.-"_'__ _ __ '_n,_. ._ ..,
<br />
<br />LAnd Total
<br />
<br />Facility A(~(;()IlIJt
<br />
<br />Facility Credit
<br />
<br />"_. --."--- - ----,--. - ,. -~.- -".
<br />
<br />Facility Total
<br />
<br />Exempt [ I Yes [J No
<br />
<br />How Determined Total Amount
<br />
<br />------.-.-..",. -----.---.-.-- "______n. ___..
<br />
<br />REsot.l ri(~E"FF.E' '''''''' ,w"'_,'_._"..""..,..~._...._"_~.",..~,, ._'._..,.._._-,..-.-._--~~"..,---_.~- En Lr''''-''---~''''--'---'-'-'''-'''''''---'--
<br />
<br />---....---.- ~'- .~.-...-.-.---.~.--...~---.- ...-...-..._~.-
<br />TUTAI. AMCllJN r
<br />
<br />__'__n.__ _ __. _ _.... ___._.____~~ ..__
<br />
<br />...... '.., ''-'''" ".. '" ....."" ""...." ,.",",........ ,..............'-'..... '.., ....- ......".. ,'-,,, ...... -..,'"-..........." .~, .....,'"~_.. .-,- ,,--'-, ...,.."._..~., ~-, ~..".",....",..,.".,...
<br />
<br />Pmp81ArI Hy
<br />
<br />Cllecl<ed By
<br />
<br />.----.- -. _'__m__.__._., __.._ .__.__..___~_
<br />
<br />NO GEIHIFIGAl'E OF OCCUPANCY WILL 81: ISSUErJ OR FINAL INSPECTION
<br />PEHFORMEU UNTIl. THE TOTAL. AMOUNTS LISTED I lAVE
<br />BEEN PAID AND
<br />I~EGEIPn=D FOR BY 1\ CENTRAL PERMITTING OFFICE OF PASCO COUNTY
<br />
<br />Acknowl8dgenlAnlIJelow does 1I0! IllIply aC(;epI8rlCe of c[JnCtllT6nce, bnt simply rAcelp! of A copy of tills fl)lI11, plAdllq
<br />Il1e 1Jlllldlng perll!l! owner 011 notice of tills assessment and the conultlons of paYllIslI! for same.
<br />
<br />DATE
<br />
<br />-. .._~-.._. '--..-----..,. '---"'-
<br />
<br />~._--_._-_..__.__..._-_..- --'---'---.-, -".
<br />
<br />nr:CEIVED BY
<br />
<br />rH::C[:IPT hlO.
<br />
<br />DAlE
<br />
<br />-~_.._- -"'...--.---.-.-....
<br />
<br />BY
<br />
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