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<br />
<br />F)ASCO COlJNlwy, FL()RIDA
<br />
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<br />I , '. I ..
<br />/ t I >- / .. / / Clll1trul #
<br />Buill 18rl'IE:HI 18 ()Wn8r 'arns __~"'...: .c_'!..t:'!.;!,.L.L./ l tdJl-f4iHh . . .
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<br />(;OIJllty hlICE3lllo. J '-I ,~_,.) .d 1-(IJ-'l(kC'._~~'~~(_i ..).t'b fJubDiv:
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<br />AddJ8SS/L()(;Cl!iOIl ,,:j /jL) l/ ;>>r-L/~)<' L;;f~0;,L ci~~._ .<T. f2it,
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<br />(.r)', !f.j', . ) /. /"} '.-/" /, /
<br />Classifil;athlllllype of IIse __ '['/TAi4.1..:.z'!~._\4_.!':'Y:!lL!'>_ .h"':"''' rk- ''(:
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<br />./) I ;-,1 /)
<br />IJenTlIlI-./Il. ,:;)". .\(
<br />, '.--,,---~'..L_.____._._.
<br />I late Pellllllled_L-'.7t..!,(l__
<br />
<br />TRANSPORTATION IMPACT FEE Hate:
<br />EX8rllp! I. I Yes \(;{ No I low Determined
<br />t
<br />[I"
<br />
<br />Illlpat:l Fee Allluunt ,.~.._ -L;-~--~:<;," ~--
<br />"'" '" ~-".- ._~,,-~"...., -:.:lit....i..':~.:!:..Q..'l, . .._...,....,.~....
<br />SellOOL IMPACT FEE
<br />Accuunt (056) 8inOle"Farnily [letadled House
<br />(0111) Mobile Horne
<br />(058) Otller Hesldential
<br />1,~L2::l) C~leGtiun Fee
<br />Exernpl ' Yes r I No Ilow Determined
<br />
<br />.,\
<br />
<br />"r' AJ~ i<s"AH f)'r~F.CRE A:fio i~' FE'f,~'
<br />LaI HI ,L\ccullnt Land Credit
<br />
<br />'-"-----'-----..-. --.-- _._--_...,.~
<br />
<br />Sq Ft IJI!it:
<br />
<br />lune No,
<br />
<br />TAL:
<br />
<br />. -,,, .~, ',.1 t."'_" _'''''''''''''''~ ..~
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<br />. ,-~,~""'.-.,.. '..,",~ ~"" ,.-. ..., ~".""_''''''''''.~ ...,.....
<br />
<br />Arnount
<br />
<br />$
<br />
<br />land Tolal
<br />
<br />neclealiulI ACCUIIIII
<br />
<br />I ~ecreatioll C;redil
<br />
<br />Hecreationf( ltal
<br />
<br />ZOlle
<br />
<br />TOTAL AMOUNl ,~j
<br />
<br />l-:X8111pl II Yes [] No
<br />
<br />Ilow Uetennins(j
<br />
<br />"'_- '0 """. " _" ~ ,.'...._,_~..__.._..~.. .-.~_._,
<br />LIBRARY FEE
<br />I,dlld /\I;(;ollltl
<br />
<br />0..._' "',,..~.,-,,,, -'.. , ....".. ..... "__'.-'''-'''~ .'. "'-.....'.".__ ~. .... ,\'_... "no,." ~"'~""" '.n.....,.".".. "._ . ,~," ....,.......,.,..
<br />
<br />li:lIHI (:redil
<br />
<br />land lntHI
<br />
<br />Fadlity AC(;Ollll!
<br />
<br />Facility Credit
<br />
<br />Facility Total
<br />
<br />Exempt II Yes I:J No
<br />
<br />I low [ letennined
<br />
<br />Total Alllollnt
<br />
<br />"""~~-~,.,~.. ,,,__,+,'........ I.' ......,.".".,.~......._....,~.. "
<br />RESOURr.E FEE
<br />TCITAl Nvl()IH'JI
<br />
<br />"",~, ,'.,' ",""'--" """''--' ."........., -, ,.-.;......, .".,> _. -',.~.' ,- ..-.< ,.,. '"."..,-.'......_'...A_., "'~"...;",~ .'...~ .......__.... ~. . ~."~,,.~"'''''''_. ,~.,., .._.."..'...................., "-'^ ._......~, .,.~.~..._'........ ,
<br />
<br />EnlJ
<br />
<br />IllHpared By
<br />
<br />Cllecl,ed By
<br />
<br />Nt) CElfI'IFICA'fe OF OCCUPANCY WILL 81: ISSUED on FINJ\L INSPI~CTION
<br />PEnFORMED UNTIL TIlE TOTAL AMOUNTS LlS'fEIl 'lAVE
<br />BEI2N PAID AND
<br />HEf:EIPTEIt FOR BY ^ c.a:NTRAL PE:RMITTING OPFIGE OF PASCO COUNTY
<br />
<br />1\c1\1 Iliwledyp.1I lent below dOBS 1I0! II Ilply aCI :eptallc.8 uf (;()IlCUrI Bllce, m,11 sli nply I 8celpt of a copy of II lis fOil n, plal:1I 1[1
<br />II," 1",11,,,," p.'",lt G"'~"'.~Q"t;!JGt "'''d'Ii''~'OI oay",.,,1 I", sa",.. .
<br />
<br />
<br />
<br />
<br />DAI F: I ~r:CEIVED BY
<br />
<br />nAI f' d>/f2l/ci I3Y
<br />
<br />f~EC:F:IPr Nt J.
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