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<br /> <br />e <br /> <br />'tiI <br /> <br />PASCO COUNTY, FLORIDA <br /> <br />-~-""~"~.~---.....",-_._"..._......_"~. -...----- --.-...-........,-..--......-. -~-...~._...._"...._...._. -....-. <br /> <br />F>el/lllt Nu. .3 crY <br />Dale Pel'lllllle-<T--~--!i~h?L_=~ <br />Bllllder l'lollle/Owller Neme --.!ifontY1_~-__..._., COl1trol1l ..__'__...._...__. <br />GlIlIlIl Y P a" ,ell'.lo '-- '- '__ _'_ __ ..______ __ ".__ _________.. S IIbD Iv: '..._u__... _ . __ ___.. <br />Address/Locallorr .. -_.3 ..235,j~ ~~ Lk,..'!y!J'lcc/r'-___._ ,_. ____.._,... _._ <br />Classlflcallol1lrype of Use -- ..-~. L~_.l~ '-~~fs--------' ....._ '_.. <br />THANSrOfHATION IMP AGT FEE Hate:__ .....___ ", Sq Ft UI1It: _...._.... __ <br /> <br />EXAltlpl <br /> <br />LJ Yes I~o <br /> <br />'1low Delennlned <br /> <br />Impact Fee Amollnt --.~-----.l 5 ~_f__._.__ <br /> <br />--~--""'. --'-"___"0 __'__. _..___ _" '____.. _._ _. __ .___.._.__..__. <br /> <br />Zone No, <br /> <br />--------. <br /> <br />TAZ: <br /> <br />--......-....,.. --.--...--- <br /> <br />AI110llnt <br /> <br />m ____-0_ nul? 2.Y _n _"__00_.... <br /> <br />-..- ...-- -_. ----. .......-.--...-..- <br /> <br />! <br />r <br />f <br /> <br />l <br /> <br />-'-'-'- ..--...-...--.---.--..--- -- .-.-----. <br /> <br />p AR j{s7\~lf), HECREATiONFE'E --.......-.--...----._____ .._.._.._....___.._._...__._..__.._. <br />Lal)(J A(;coun[ Land Credit Land Total <br /> <br />~.._---_. -.. -..------. <br /> <br />ReCI'88liun AceD I "It <br /> <br />-----.- <br /> <br />-..- ..--------...______."4 <br /> <br /> <br /> <br />-.-----. -.-----.---. <br /> <br />LUlie <br /> <br />--- .------- <br /> <br />r~Acrealion 'Total <br /> <br />-.-.--.....- -....-..- <br /> <br />'-'-"'... --.--..--.-----...- <br /> <br />Exelllpl <br /> <br /> <br />TOTAL /\MOUNT..J_..___...__ <br /> <br />Ilow Determined <br /> <br />~ <br /> <br />'Lr~ '~""nY FE E ....-......"". ...... ...- ...---.... .........-..~--.-..-_...~...-_.._-..-...-..._._~......... .......~-..-~.ft...._.______".___..~.._~ <br /> <br /> <br />Land ACCOtllll L.and Credit Land Tolal <br /> <br />--.----- "-----.. ----. -- --- ".-'-- ----0-.. .____.._.___.__.. .__......_... __,__. <br /> <br />. ----.-..-..-..-.. ---.----. <br /> <br />Fa<.:lIily Acc;oUIlI...._______.....__ <br /> <br />"--.--.----... <br /> <br />EX8111pl <br /> <br /> <br />"-- "- --., -- ---....---- <br /> <br />-..-..------------.-- - <br /> <br />Facility Total <br /> <br />How DetelJlllned <br /> <br />. ----.----..--------- .,;:=.. <br /> <br />~(~~~iJ~~~~:_~::-;[~~~~~~~~,~~~"~"~~~~.__.=-~_~~~~~= <br /> <br />--'-.-- ---" -~--~-- <br /> <br />Toted A1'I1011llt <br /> <br />---_..~..~,- -. ----. <br /> <br />Prepared By -...--__..____________.________________._. Checl<ecl By <br /> <br />---- - .-.---.--- --..-.-.-- ..-._.._-.~..._---_.- ...,---.... <br /> <br />Nfl I:EHTIFIGATE OF OGGlIPANGY WILl. BE ISSlIEfl OR FINAl. INSI'E!; I"ION <br />PErU:OJ~ME/J UNTIL TI.If: TOTAL AMOUNTS I./SlED I lAVE <br />BEEN PAID ANn <br />m:cr-:/f--'Tf:IJ FOR BY A CENTRAL PERMITTIN(~ (W'PICE OF PASCO COlJNTY <br /> <br />Ado'OWI."g.IIl.II! below does 1I0tlrllply acoeptalloe 01 (:OIlGlIlrOlloe, bul simply r.Gelpl of a copy of IIrls form, plaGIII" <br />1118 l)lIl/dlng permit owner on no lice of Il1ls assess/nen! and Il1e condlllons of paYllIent fur same. <br /> <br />--. ---.-.~- ---.- ---.. <br /> <br />DATE <br />r~ECEIr-)'r' r.J(). '::D0J2_}()A'!'E <br /> <br />'.0_ _._._... .."__. __. ."_"_ ,...__. ._. ...._.. . "_. <br /> <br /> <br />v. <br />..... <br /> <br />r <br />I <br />i <br />r <br />r <br />" <br />f <br />.... <br />f <br />t <br />r <br />~ <br />