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<br />PASCO COUNTY, FLORIDA
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<br />""---'"""".....'-"'"...~......,..,.,......-.ruo.....,"'..,"'....,......,.,..........~,....""~.-..-..",.,,""..,,...O:,.'....~_...~_,........"~.,."..._'~....,.".-,,~'~'~.h.......-.,.,"'.-..-~.._.,.....--_.~'''''.....,_,..,._~...,...,,...,..'.'crt"'I-._ ....,"'..Qt",....."
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<br />Permit No. .-_____-A~_____..
<br />Date PermlHed _-:l...:..!:.1:J!.-"'?..._
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<br />Builder Name/Owner Name 10 ~A.:X t [i {~ (i &...5 Control tf.
<br />------- ---...------.;---------- --- ---------. -- --.
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<br />--- .---.--------- ---._.~._--.-.--~,~'.
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<br />COLlIll Y P arce I No .____ "_ ____._..__.__....____ _-..._ ._._____________ S u bD Iv:
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<br />----_..-_._.-._.-~.- ---.-..----.-.--...
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<br />Ad d ress/Loea tlo n .. --_(oLtQQ_~ Lt\L e-y flt:..J:. ~._ ck.:____________ ___n__....__ "_ __________..___..______
<br />ClassiflcatlOll/rype of Use -SJl~-.i~~.~-_J-w~~~---..-__--..---._-.. ___________
<br />Tr-{ANSP(H~ rATION IMPACT FEE Hate: -.----__n._ Sq Ft Unit: __._ ______.__.._
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<br />Exempt
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<br />[(]/res [J No
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<br />How Determined
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<br />---~-._- -------.---.. -- .--....--..-, "-- -----.....
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<br />....-..'---...---..-.-. '.. ,-~-,.-
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<br />Impact Fee Amount _1.______.__..______
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<br />Zone No. TAZ:
<br />
<br />-----------. --_..._.-...-..._--------_._~-
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<br />sciiOor:j'NiPACT.FEE-"---~..-'-"-"'_._.ffl..~.~.-~.-,~..~--~-"._~-,"-'=-_.,,"---,,-..-_>..__.__,__.~
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<br />Account (056) Single-Family Detached Ilollse Amount $ ----..----.-~~2'1..--..----...
<br />(05.."7) Mobile Horne __._____ __on__._____, ___,____.
<br />(U513) Other Residential ___ __.____._________._______
<br />JI2:3) CgJ!ecjloll Fee
<br />Exempt I J Yes L_+-No How Determined ___.._______________.___._________________
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<br />PARRrrA~m.RECREATiON FEE --.-.--...-----.------~--"
<br />Land Account Land Credit
<br />
<br />----
<br />
<br />-..._-..._--~_..,~._..,._._.
<br />
<br />
<br />""-----_....._..-~ ------...-..-..----
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<br />Hecreat!on AccOl" It
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<br />
<br />Recreation Total
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<br />Zone
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<br />TOTAL I\MOUNT
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<br />..._.!!l_. ________ .__,___ ..._ ____..___...._
<br />
<br />[] No
<br />
<br />How Determined
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<br />1:r8"R^Ry'FEi~"......_.,._.~..,..,,-.-."'""'--- ,..,....-,..-..-..-.._...~u._...,,'_...,...__~"'_.....,,_...~..._-._~"__...==----:::-:::~___......._.,_._.
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<br />
<br />Land Account l.and Credit Land Total
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<br />-"------'---.--... -'------.- - ~.__.,. ,.-..--.--- --- ~._-----..._~-_._--.~,--. -,--
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<br />. -~-----..--. -..,', ._..~ -.----.-------
<br />
<br />--..------.-.--.-,--.
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<br />Facility Account
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<br />~-- '-_._---~.,--_.---_._---,._-_....
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<br />..._.__..________..__.._ _ Facility Total
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<br />--------------..-----.-
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<br />1.-_.-.1 No
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<br />How Determined Total Amollnt
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<br />~~-"---._.-..,--~-------.-~ --------_~__ ,_, 0 __."~____.__
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<br />-.-'--....'-.--....,.."'-.-,.-,...~,.-,.,""""".~..,.--.............,...-,...",........_\A:~~,.._-__..~............,__..............._......,..,~'"""._"',....,_"'-,__~.....~..."'...._,...,_......,.,_.._~"__~",.""...........~_...................,_~___.....
<br />RESOURCE FE~ ERU
<br />TCJ1AL AMOUNI'
<br />
<br />"' ..~----_._~--.-~,._._--------
<br />
<br />-~-- -..'-----.... -------_._---------~
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<br />-,".----..-.-...-.., -.-..__'v~.....__"._~__.~...__..._._...~_.._..._....._."_~'____~__',."_._._.....__..____.._
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<br />Prepared By ---tJ.tc.t_._._~__________ Checl<ed By . ____. ..~_._ __.__._____
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<br />NO GF.HTIFIGA'TE OF OCCUPANCY WILL BE ISSUED on FINAL INSr'EGTION
<br />PEFU=ORMF-D UNTIL THE TOTAL AMOUNTS t.!STED HAVE
<br />BEEN PAID AND
<br />'~EGJ::IPTE[) FOR BY 1\ CENTRAL PERMITTING OFFICE OF PASCO COUNTY
<br />
<br />Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a copy of this fOlln, plaGlnq
<br />the building penlllt owner on notice of this assessrnent and the conditions of payment fur same,
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<br />-DA;fE- -.... .... - ----- ---- -- u_ ..----.. - -.
<br />RECEIPT 1\10. .1f~?~__. DATE
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<br />./ nr:CEI'/fD 8YjJ
<br />4--~-fPS-- BY-~p-_._.._....
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<br />~---'----- -.._-- -..,.--..- ----~"--'-' --".. ..-.-.- -- --'-'--"
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