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� � <br />' • + � � � <br /> �' � <br /> ,�, � <br /> � , <br /> _ �= PA��CJ CCtIiNTY, FLC3�IC�A <br /> ' � . <br /> .,;.: , <br /> J. <br /> � � permit No, �� <br /> Date Permitted — 2—/ <br /> � �r <br /> Bui�der Name/�wner Name t ' �lG� /���'d' Control# <br /> Counfy Parcel No, � _ ?�—�. �(� I _ —��°d SubDiv: �r � V��'cti(„�� <br /> i <br /> AddressJLacation � � j c� W���- � L`�" � <br /> � " <br /> Classification/Type of Use �� �., , ' c�i ��r.�.�z� <br /> TRANSP�RTATION iMPACT FEE � Ra�te: Sq Ft Unit: <br /> � Exempt [� Yes [� No How Determined <br /> � lmpact Fee Amour�t $ � ��= Zone No. TAZ: <br /> SCMUOL. lMPACT FEE <br /> Account (OS6) Single-Family De ached House Amount $ ������ <br /> (057) Mobils Home <br /> (058) Qther Residential <br /> 123) Collection Fee <br /> Exempt Yes [� No How Determined <br /> PARKS AND RECREATlON FEE , <br /> Land Account Lan Gredit Land Tota! <br /> Recreation Account ecreation Credit Recreation Tota! <br /> Zone TOTAL AMOUNT $ ��p� ��, <br /> Exempt � Yes [] No How Determined <br /> LtBRARY FEE <br /> Land Rccount Land Credit Land Tatal <br /> Faciiity Account Facii ty Cred�t Facility Total <br /> Exempt � Yes ❑ No How Defermined Tatal Amaunt <br /> � <br /> RESOURCE FEE ERU <br /> � <br /> TOTAL AMOUNT <br /> Prepared By , � I Checked By ' <br /> � <br /> NC} CERTlFICATE OF OCCU ANCY WIL.L BE 1SSUEb UR FIFJA� tNSPECTION <br /> PERFt�RMED UNTI THE TOTAE. AMOUNTS �iSTE� NAVE <br /> BEENIPAID AND <br /> RECEIPTED FOR BY A CEN RAL P i RMITTING OFFlCE OP PASCO GOUNTY <br /> Acknowledgement below does not imply acce tance of concurrence,but simply recelpt of a copy af this form,placing <br /> fhe buiiding permit owner on natice of this assessment and fhe conditions of payment for same. <br /> DATE RECE{VED BY <br /> RECEIPT NO. DAT BY <br /> � , <br /> , <br /> . .. , .. � I <br /> � � <br />