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<br /> <br />Builder Name/Owner Name <br /> <br />(;(lllllly PArcel /'10. <br /> <br />- .- .~-------- <br /> <br />Address/Location -_L1 C.U_~___._S!~__~ <br />Classificalhlll/lype of lJse])~;:~~l~Y--,-_.__._____._.______ <br />TRANSPClFHATION IMPACT FEE F~ale: <br /> <br />.------'-~._--_.__._.~ "'- -----------.------ <br /> <br />Sq Fl Unit <br /> <br />F.:X8l11pl I.J Yes '--J No <br /> <br />---. -. '-.- ---~~_.~-.- <br /> <br />Ilow IJetennlned <br /> <br />... _. - -- ____. --~- '--'----"" <br /> <br />--_.-._--.~---- _.,- .---- <br /> <br />Impact r=ee All1ount.l.._lt'- S_~.~__._._ <br /> <br />Zone No. TA7: <br /> <br />--._-_._---~-_.._-.---- -----,._,~.. ~~----'----.._._- <br /> <br />~~.~~~~[jM(~~~T "!i~~:~'~~)::G1;:~;~::"-"~:::,~" '~-'-"-]R7;~-.-;;;,-~- <br /> <br />(057) Mobile '-Iome h___.__.__...... <br />(U50) Otiler Residential _. ...___.... ,__... . .._.___... <br />.1'123) Collection Fee <br />Exelllpt '-J Yes [I No /-low IJetenninerl -..---.---......-.h._..n..._______. <br /> <br />PARi<s7\~m' R EC REATiorJ FE'i~--' -...".~....._,.~.,,---~._--~..------...'"-....--. ~._~.... ____"._.... ._,..,,___ "_~._.... <br />Lalld ACCOUlll La11l.1 Credit Land Total <br /> <br />r~ecleatioll Accuullt necreatioll ere!. . r'{ecreatiol! TotAl <br /> <br />"". - --.----..-. ..------. ...- -------. ---.. ...--.-----...,....-.-,--- <br /> <br />Z(lIle <br /> <br />" . _.b_. "_'n.. _"_ '_ _.. '_'_ 'm _"'m___.. -"" <br /> <br /> <br />TOTAL AMCH.1I'Jl <br /> <br />ji._ ___.. <br /> <br /> <br />(mjl\Jo <br /> <br />Iluw Uetennillscj <br /> <br />.i'.iBR;;j~V FEE........... <br />I.alld /\(:COIIIII <br /> <br />. --. -..---- ...____..._n_ <br /> <br />. .... .. .....,..._.,... '..,. .....,_..u.. ...._...._.'''..." ,"", ''',.,,,_.,,,,,,.... .... ,. ...'^.....~.."_......_._.~._._...._...__._".....,,.... ........ <br /> <br />1.811<.1 Cledit --~I Tolal <br />___ .-....-.--n,_....m ____ __.. <br /> <br />Facility ACCOlltll <br /> <br />-.- ,_. '----,--"- ._'.- ----'----'---- <br /> <br /> <br />facility Credit _______.__..._.._ Facility Total <br /> <br />[J r'~o <br /> <br />...---.-~.---- .___.u____~.. <br /> <br />.-.,..........-.- .;....~."..- ..~....~_._--..,. . , '.." <br />RESOURCE FE~ <br />TOTAL AMUUr{J' <br /> <br />How Uelellllinsd TotRI Amoullt <br /> <br />- -- ..------. .---....---..-. ----.--..-.--.- <br /> <br />....-...... "1" ...--..._.."m..... -, ........-....--. ~."..._-,-~~... ~........._....ER[ j"..--.--..".....-------.. ..---......-... <br /> <br />--.--_~ L..[~_ .______.--.....------.--.-n.--- <br /> <br />Pr81lared By - ..______._._.... .___._..__._____ Checked By <br /> <br />. .. ~......."....'..... ...~..._..-.-..-."'....~......-....--._-"...-.-......... .."..... "---- , ...........~.....-'..._m..._...-. ......,....."..._...__._~...___.._..._. <br /> <br />.-----.. ._-.. ---'-'---.0_..- ..__.__.___.. <br /> <br />NO CElnlFIGATE Or: OCCUPANCY WII..I.. BE ISSUED on FINAL INSPECnON <br />I'Eru=OHIVIEU UNTIL '1 lIE TOTAL AMOUNTS I.ISTED I lAVE:: <br />I3EF-N PAIIl ^"'n <br />