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' ` _ �'A��O ��►IJNTY9 F�.��I�A <br /> .. . Permit No. ����� <br /> Date Permitted S-ZZ-� <br /> Builder NamelQwner Name �jt��,�Y �(,� 1Ll !�- Controi# <br /> County Parcel No. � (��-Z6� -Zt-t����p_ Q(��p- ���j j�� SubDiv: /itlCl(�tcc�`�rdt��Cu>✓lydr. <br /> AddresslLocation ,3��j� �Y Gti f;�„ ��DSE L,� j_ t Z <br /> ClassificatianlType of Use �Gt)i`1 v��r� <br /> --�r-�i����� <br /> TRANSPORTATION IMPACI"FEE Rate: Sq Ft Unit: _��u <br /> Exempt [] Yes � No Mow Determin�d <br /> Impact Fee Amaunt $ �`�'�a Zone Na. TAZ; <br /> SCHOOL IMPACT FEE <br /> Account (056} 8ingle-Family Detached House Amount $ r�i'� <br /> (457) Mobile Fiome <br /> (058) Other Residential <br /> 123} Coilection Fee <br /> Exempt Yes � No How Determined <br /> PARKS AND REGREATION FEE <br /> L.and Account Land Credit Land Total <br /> Recreation Account Recreatian Credit Recreatian Total <br /> Zone TOTAL AMQUNT $ �� � -�5�, <br /> � Exem t Yes No tiow Determined <br /> P ❑ ❑ <br /> LIBRARY FEE <br /> �and Account Land Credit Land Total <br /> Facility Account Facility Gredit Facility Tata! <br /> Exemp# � Yes (� No How Determined Total Amount�.��'' <br /> RESOURGE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By t Checked By <br /> NO CERTIFICATE OF OGCUPAh1CY WILI.8E ISSUED OR F1NAL IPISPECTION <br /> PERFORMED UNTI�THE TOTAL AMCIUNTS LISTED HAVE <br /> BEEN PAIp ANQ <br /> F2ECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUPI`TY <br /> Acknowledgament below does not imply acceptance of concurrence,but simply recelpt of a copy of this farm,placing <br /> the building permit owner on notice af this assessment and the conditions of payment for same. <br /> DATE RECEIVED 8Y <br /> RECEIPT NO. DATE BY <br />