Laserfiche WebLink
,� <br /> : �� �� �ourv�r�, F�o�i�� <br /> Permit No. ---��l� <br /> �afe-�8rm'rxt"e <br /> l�,��ec��� <br /> Builder Name/Owner Name , ;, ��� � ,; � Control# <br /> County Parcel No. � s�- -�Z(Q�(j(,�( C Z� SubDiv: ��,� � ��.����.c,� <br /> Address/Location ;3 7 7 5 r�ili��� �j� � <br /> Classification/Type of Use ` �l�yv� � <br /> TRANSPORTATION IMPAC FEE Rate: Sq Ft Unit: 7GZ� <br /> Exe <br /> mpt � Yes No How Determined <br /> ❑ <br /> I Impact Fee Amount $ j Zone No. T,qZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-F mily Detached House Amount $ _ ��- <br />� (057) Mobile H me <br /> (058) Other R sidential <br /> 123) Collectio Fee <br /> Exempt a Yes � No How Determined <br /> PARKS AND RECREA <br /> TIOM FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7C`�-�.E, <br />� Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount , <br /> I RESOURCEFEE ERU <br /> TOTALAMOUNT <br /> Prepared By "Q� ' �, Checked By <br />�� MO CERTIFICATE O OCCUPANCY WILL BE ISSUED OR FINAL INSPECl'IOM <br /> PERFORM D UN71L THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br />� RECEIPTED FOR B A CENTRAL PERMITTING OFFICE OF PASCO COUMTY <br /> Acknowledgement below does no imply acceptance of concurrence,but simply recelpt of a copy of this form,placing <br /> the building permit own r on notice oi thfs assessment and thQ conditions of payment for same. <br /> DA7E RECEIVED BY <br /> d <br /> RECEIPT NO �DATE BY <br />