|
<br />
<br />PASCO COlJN-rV, FLORIDA
<br />
<br />-"~=--"-'-' .,.... ..,~, .....~....~,...."' "".-'-, '."~.,~ ~
<br />
<br />....~~.... ',t".,,,... 'C'....".."...~.'~..,' .........,...~'..,.....;..,...., c" "'..0."".,.',....." .". 0-. ....." ".:0'.. "..,'..... "","," '....".." '-~... '.'., .._..'~,*-"" ...><._,'-.~_.._ ,~"" ,,_, '__"~...n..., ~"._...~.o.'.:o
<br />
<br />,: I
<br />1l1lildHI /-jClIllS/()wner Ncune . f, ,~\.l_I/.:..4!._ J//j,C'!L_/?!Z/-,!_. COlllro/ if
<br />
<br />(;OUllty Pa(cellh .-~3 (L~_Lll;.0 L~.(~l(l\(.) --~~~~'~('u1lIsubu,v:
<br />
<br />~ ", . ,) / I " ._
<br />Address/Loc:~tioll . ,.~LL.l!.:-\~~_.J:../~u:,if___Li.;!.C_ ./:L
<br />
<br />I)elllllll\/n. .....:dlre) '".
<br />Date Pelll1Ilted...,;:i i- t/ (
<br />
<br />(
<br />Classificati( JII/ lYI Je of Use
<br />
<br />'J )"/,.1 ,
<br />/Dy:!L:L.c ~..
<br />
<br />
<br />
<br />'I RANSPOIH'A'r10N IMPACT FEE
<br />
<br />nate:
<br />
<br />Sq Ft Ullit:
<br />
<br />f~xelllpl I. ] Yes tT'tJo
<br />/
<br />
<br />Ilow Uetennined
<br />
<br />Illlpac;! Fee AI1IUIllIt $ __j~ ..i_".)./~~ ~_ ~_'~' lone No, ._____
<br />.).1 , 1 ,// n ,
<br />.s'cTi6()-CiMP"AcfF'Et<~"'"..~" ".. ~..:.:L_.E",;,~"L"'~'""M"'_"~"_"'~,_,~,,, ~ ,
<br />Ac(;uunt (015A) SinOle,.Family DetE1clled HOllse Amount
<br />(Ofi1) Mobile HOllie
<br />(ORB) OllieI' Hesidenlial
<br />\ (}2.J) (;~llection Fee
<br />Exelllpt !XI Yes L I No Ilow Deterllllned
<br />
<br />TAL:
<br />
<br />',. -..co,""""""'"",...., "', --', """- ,',,~... .__............-........,."'_,. "'.,.....->......,..."....o..~...-...-"'....
<br />
<br />'I'
<br />d
<br />
<br />"PAR RifAN fiREC REATirj'frF EE' ---...--...-..-, '.......",_._-", ..........,....-.,. ~=-""""'" '..'_ ,._"." ..,.... ._....~__~~..._.__.._.
<br />Land Account Land Credit Lc:md lolal
<br />
<br />. ,
<br />
<br />'- -.-,.. ----.. -"'.'--,
<br />
<br />neCI tiEl lion Ac:cut lilt
<br />
<br />necreatioll C;reclit Hecrealion Total
<br />
<br />LUlie
<br />
<br />[:X8Illpl I) Yes
<br />
<br />TUII\I. AMOUNT .t_
<br />
<br />I t'Ju
<br />
<br />Ilow !Jetennined
<br />
<br />'....' '-.-.. ....~.. .,',<~..... _. '-'~.' ... . ........,
<br />
<br />LIBRARY FFE
<br />Land !\(;(:{)ulll
<br />
<br />",,' ._~'-L",.,_,,,... T~_ ~'''_''
<br />
<br />..-..L.......',. '.'. ..~,_,.. l. ; ~ ->, ." .." "";.~" _.-"...~...,.... " .,"., .........."..~_"
<br />
<br />Land (~I edit
<br />
<br />'-..--, -,- -'--". - '--'..____ ~ _ .u.
<br />
<br />Land Total
<br />
<br />Facllily ACC(llllll
<br />
<br />I:acility C:redit
<br />
<br />Facility Total
<br />
<br />EXf::!llipt I I '(es LJ NfJ
<br />
<br />Ilow Uetel/nined
<br />
<br />., of:al Amollllt
<br />
<br />........._..,.,.,~"."--,... . .."", "~ --.,......~-..... .-.".,,-,......"_..t-"~,._._.. ""'."C_'" L..~'-,.'
<br />
<br />RESOURCE FF::E
<br />'II n Al MvlOUNT
<br />
<br />"'.,, .,-... ..."" ,-'...........,.....<-..,...",- ,.~." -""-=. '..,,-, "..........."-~ ""'-..,.. ..",.... ...'''.....-.......,. .."..., "'~.. ......", -" -'"
<br />
<br />ERU
<br />
<br />1....'--<--_'".._.-,,,-..,,,.._-,,,
<br />
<br />Prel lared 13y
<br />
<br />. .' .. . ..... -.,,~ '.'~. ~'-'" . - '...' -- '-'-'''''''-._-- -............. .,-., ~"'-',",---.",-.~ :....... - . . ,.... ., '--" "' d .'_' __, ". . w _,.__ "'.',u". ".'~"
<br />
<br />---,+ .' . ,. '" ,.,~ c. ..~ ......,,,....,.... '''''n'". '''''. ,. '."_""'~__.""~"',,,,,,~
<br />
<br />Checked By
<br />
<br />I,J() CEHTIFICATE OF OCCUPANCY WILL B1: ISSUED on f::INAl. INSPECTION
<br />PEf~F(JRMF-n UNTil. lllE rOTA I. AMOUNTS LlSTEU 'lAVE
<br />BI:EN PAID ANI)
<br />1~J::CEJP'r'l:':n F()f~ l3Y 1\ CENlHAi.. PEr~MITIJNG OFFICE or: PASCO COUNTY
<br />
<br />.-.---.
<br />DAIF
<br />
<br />Acknowledgement below does lI{1t "nply acceplanr:e of CO Ilra Hlence , bill simply receipt of a GOPy of Ihls form, placlnu
<br />IIlEl 1IIIIIdillY permit owner OIlIH!tk:e of lids assessment and thtl GOlldillolls of payment tor same.
<br />
<br />' ffL JO. '6&/
<br />
<br />'u ,~I>-~H__'__ ..__
<br />"'~ -j~f-:CF:I\lEf) [.1V "H
<br />
<br />nE< :1':11>1 N< J.
<br />
<br />DA'Ffpl (J1!OJ!l3v
<br />
|