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<br />PASCO COUNTY;.PLORIDA '.
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<br />I , Date pomiltiSd . 'fJ JJ5f A ~. ,
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<br />'coun'Vpaice,INo. O!S-AL.-~I-:l?~-~~" ~1Ql)~!y= 8~'~er 0n~~ \l~ llaS~ . "'\:) \:) "
<br />'/Wdre:tlilLooatlon $.~Iola..~ Pirl<9..u., ml (( Q..u.6L - /....or -.iQ . .... ~
<br />C/aEilllflOlluOn/T'ypaOfUsV .s,~11I 'c;;..~.i L..t Q~,~o - "
<br />l'RAHSPOR'rATlON IIIPAcr e.. '. Rate;! . ' . ' __ Sq ~ Unit; ~ I,' ,1
<br />r=xsmpt ~tl6 CJ Ng . 1i0lN o~ : , '
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<br />. '~qctFHAmcu.nt $.. ~", ~ftf"NO~,'
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<br />Acnount (066) S1I1Qle-F~IyPetaahed t'kJlJiie Amount' ,~~:b", \Li
<br />" (057) MopllEt Hams' !
<br />(068), 'OtMr~BltllaI" .
<br />. .' 28) glfgn flee" .
<br />Exempt ,rB v,. 'g'NO How ~ . ' : '".
<br />PAmur.-ND'RI!~REATlDNr='" ". . ,: ." .:--:- ., '~:-~
<br />Land AGalunt .' LMnd crsdlt ~LIU1d Tgl8l, ,
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<br />Zona . ./:.-. . . . ' . TOTAL..AMOUNT'. J
<br />~m~ '-0 Yos 0 No HoW.QeterinnHI "..-- '
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<br />f.uIIJty Accoum, Paatll1y ~dIt ';., Facdty TClCIl
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<br />NO Q.Ri1FICATE OP DGCURANCVWIU. ~ aSsI:J~ OR F~NAL IN8P&CTION
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