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-l,nltlal CERTIFICATE OF CAPACIT REQUIRED FC :Is, REZONINGS, PREI-IMINARY SITE PLANS, Ph _ ANARY PLANS, NON-RESID~,. /AL SLIBDIVISION, RESIDENTIAL SUBDIVISION INTO MORE THAN ONE DWELLING UNIT PER LOT, AND PUBLIC SCHOOL COMPREHENSIVE PLAN CONSISTENCY REVIEW To Be Completed By Department Responsible For Approval Sought; Completed Certificate Must Be Attached To the Agenda Item and Approval Document Completed Application Received On (Date): Certificate Form Completed By : Parcel I.D. #'s: See Attached (attach survey if project includes portion of parcel) Project Name: Livinaston Subdivision Name: TAZ No.: 245 TAZ Map Version: GIs Applicant Name, Address, and Telephone Number: c/o Tew & Associates, 727-451-0615 Job Site Address: Project has direct connection (See 402.5.C.5.A.) to following collectorslarterials: Aggregated With Another Project?(See 402.5.C.5.B) Yes x No (If yes, identify project name and I.D. No. Prior building(s) on or after January 1, 1985? Yes x No (If yes, identify use and unitslsq. ft. ) Approval Sought (Check all that apply): - DRI Non -Residential Subdivision Rezoning Residential Subdivision Into More Than One Dwelling Unit Per Lot - Preliminary Plan Public School Comprehensive Plan Consistency Review - Preliminary Site Plan TYPE OF DEVELOPMENT (Use TIS Exhibits for land use description and units of measurement and if not on Exhibits, use ITE land use codes and description) (If not restricted by applicant, use maximum allowed by requested (rezoning or DRI) or approved (other approvals) zoning or land use, whichever is les: Residential Nonresidential x Single Family 1240 Specific Use 1 - sq. ft. Mobile Home Park 1 - sq. ft. Congregate Care Facility 1 - (specify uni Apartments x Low-Rise Condo/Townhome 540 Storage1 Display Area 1 - sq. ft. Hi-Rise Condominium (3 or more stories) Other Residential EXEMPTIONS AND LIMITED EXEMPTIONS (Rec *EXEMPTIONS (See 402.6 and Concurrency Applicability): A. ALL FACILITIES Approved school consistency review or preliminarylconstruction plan prior to December 1,2006 Complete application prior to December I, 2006 (Apply old 402 and TIS Guidelines) Unexpired Certificate of Level of Service Compliance Unexpired DRI approved prior to April 9, 1991 B. ROADS ONLY Unexpired Initial Certificate of Capacity Unexpired DRI applied for or approved prior to December 1,2006 Unexpired Traffic Study Completed After June 4, 1999 Unexpired approved Traffic Study Methodology Prior to December 1, 2006 (Apply old TIS Guidelines) Unexpired approved Development Agreement exempt from transportation concurrency Exemption Expires On: Exemption Revoked On: ires ) *LIMITED EXEMPTIONS (See 402.7; requires signature from County Administrator or his designee): Public School or School Required for School Concurrency Governmental Building or Use Target Business (requires letter from PEDC) Employment Center Affordable Housing (requires letter from Community Development) TND Development Exemptions (check all that apply): Impact Fees or Interlocal Agreement As Proportionate Share (Roads Only) Traffic Study Waiver (Roads Only) 3 years committed capacity vs. 1 yr. (Roads Only) Extension of Certificate wlo Additional Revie! Other (requires CAO approval) ISSUANCE DATE: Authorized Growth Management Signature (Use date of final zoningldevelopment order approval) EXPIRATION (See 402.3.A.): All Facilities (other than roads): Certificate of Capacity Expires (or subject to additional review) On: Revoked On: Relinquished On: (6 yrs from issuance) Roads: Certificate of Capacity Expires (or subject to additional review) on:- (GM to complete) Revoked On: Relinquished On: *Completed Certificate of Capacity with limited exemptions or with exemptions for which no prior certificate of capacity has been issued must be distributed to the following: (1) Growth Management Administrator, (2) Engineering Services Director, (3) Parks and Recreation Director, (4) Transportation Manager, (5) Development Review Director, (6) MPO Transportation Planning Coordinator, (7) Assistant County Administrator for Development Services, (8) Assistant County Administrator for Utility Services, (9) OMB Director, and (10) BOCC as a noted item on agenda (excluding (3) and (8) if exemption is for roads only).

CONCURRENCY REVIEW (To Be Completed by Department Listed Below Only; Leave Blank if a 402.6 Exemption Applies) Com~. Plan Elements Meets LOS Std. Review Standards Conditional Yes No Approval(attach conditions of approval or list Roads (Growth Management) LDC 402.5, Transportation Element 2.4.1 and TIS Guidelines WaterNVater Supply (Utilities) 0 0 0 LDC 402.4.A. and Public Facilities Element 1.I and 1.3 Sewer (Utilities) m u 0 LDC 402.4.A. and Public Facilities Element 3.1 ParksIRecreation (Parks) 0 El m LDC 402.4.B. and Recreation and Open Space Element 1.I Solid Waste (Utilities) I3 0 0 LDC 402.4.A. and Public Facilities Element 4.1 Mass Transit (Public Transportation) n LDC 402.4.A. and Transportation Element 5.1 Reviewed by:?ks-c k..l..a( \ : fi 9\,2uu,uA \WELCrn" \.x- ~itre Date

LIVINGSTON lvlpud 25. The developer has submitted a traffic study that was reviewed by the staff of the County. Prior to approval of the first record plat, or where platting is not required, prior to the issuance of the first Building Permit, the developer shall construct the following siteaccess improvements: a. Design and permit for 4-lanes and construct a 2-lane road within and to the boundaries throughout the project on Oldwoods Avenue, Wyndfields Boulevard, andlor Beardsley Drive (2-lane design only) in phases to be determined in the Master Roadway Phasing Plan, to be approved by the County. The Beardsley Drive requirement may be deleted by the County after the planned Route Studies, above. b. Construct turn lanes to the project driveways and at the intersections of Oldwoods Avenue, Wyndfields Boulevard, and Beardsley Drive (if applicable), as determined during site plan review. Prior to or concurrent with the first record plat, or where platting is not required, prior to the issuance of the first Building Permit or December 31, 2015, whichever occurs first, the developer(s) shall complete or the following off-site improvements: Phase 1 (Up to 600 residential units) Site-Related Improvements: a. Construct Oldwoods Avenue as a 2-lane undivided roadway from Meadow Pointe Boulevard to the project entrance (if not constructed by others at an earlier date). b. At the Meadow Pointe Boulevard and Oldwoods Avenue intersection, add southbound and westbound left turn lanes and the westbound right turn lane (if not constructed by others at an earlier date). These improvements are site-access related and shall not be impact fee creditable. Off-Site Improvements: c. At the Beardsley Drive and Mansfield Boulevard intersection, prior to the first record plat, or anytime at the County's request, the developer shall pay for and perform a signal warrant study and signalize the intersection when warranted by the MUTCD (if not constructed by others at an earlier date). d. At the County Line Road and S.R. 581 intersection add a second southbound left turn lane (if not constructed by others at an earlier date). The project's proportionate share amount for items c. and d. of the foregoing Phase 1 improvements is $94,651.00. Construction by the developer of c. and d. shall satisfy $94,651.00 of the projects proportionate share obligation. If any of the off-site improvements are constructed by the County or others prior to the applicable deadline set forth herein (600 units), the County may require an alternative irnprovement or a cash payment which shall be determined prior to preliminary plan approval for the 600th unit. With respect to the required improvements for Oldwoods Avenue located outside of the project boundary to the project boundary, the County shall continue to enforce the existing obligations of the other third-party landowners to donate such off-site right-ofway, pursuant to their existing and any amendments to their respective development orders and/or development agreements. The County and the developer will cooperate to seek coordination of such off-site right-of-way donations consistent with the County's planned Route Studies, and to meet the construction needs of the various, affected projects. Prior to or concurrent with the first record plat, or where platting is not required, prior to the issuance of the 601st Building Permit or December 31, 201 9, whichever occurs first, the developer(s) shall complete or the following off-site improvements:

Phase 2 (From 601 up to 1800 residential units) In addition to the improvements indicated for Phase 1, construct the following: a. Widen S.R. 56 from Mansfield Boulevard to Meadow Pointe Boulevard from four lanes to six lanes. b. At the S.R. 56 at S.R. 581 intersection, construct a grade separation to carry six through lanes on S.R. 56 and construct an at grade intersection to include dual left turn lanes for the northbound, southbound, eastbound, and westbound movements, three through lanes for the northbound and southbound movements, and a single right turn lane for the northbound, southbound, eastbound, and westbound movements. c. At the County Line Road and S.R. 581 intersection, add a westbound right turn lane. d. At the County Line Road and Mansfield Road intersection, add dual eastbound left turn lanes, a second northbound left turn lane, and a second southbound right turn lane. e. At the S.R. 56 and Mansfield Boulevard intersection, add third northbound and southbound left turn lanes, a second westbound left turn lane, and construct an eastbound receiving lane on S.R. 56 (0.25 mile long) for the northbound right turn. f. At the Beardsley Drive and Meadow Pointe Boulevard intersection, add an eastbound left turn lane and a southbound right turn lane, and signalize when warranted by the MUTCD. g. At the S.R. 56 and Meadow Pointe Boulevard intersection, add second northbound and southbound left turn lanes and a southbound receiving lane (0.25 mile long) for the eastbound right turn movement. h. At the Beardsley Drive and Mansfield Boulevard intersection, if not signalized in Phase 1 or constructed by others at an earlier date, prior to approval of the last record plat, or anytime at the County's request, the developer shall pay for and perform a signal warrant study and signalize the intersection when warranted by the MUTCD. i. Construct Beardsley Drive as a 2-lane undivided roadway from Meadow Pointe Boulevard to the project entrance if needed for project access. The Beardsley Drive requirement may be deleted by the County after the planned Route Studies, above. In lieu of the above-mentioned off-site improvements, the developer(s)/applicant(s) shall pay a proportionate share in the amount of $9,352,932 for the improvements specified in Condition No. 25, above. This amount is based upon 2010 dollars. However, the estimated transportation impact fees for the project, based upon the total of 1800 residential units as analyzed in the approved traffic study, is $21,200,000.00, based upon 2012 1'IF schedules, which substantially exceeds the proportionate share obligation for the project, as approved herein. Therefore, the developer may pay the applicable transportation impact fees when and as due for residential units (as completed) under the applicable impact fee ordinances, which shall be deemed to satisfy the developer's proportionate share obligation. Notwithstanding the foregoing, the developer shall not proceed beyond Phase 1 (600 units) unless and until S.R. 56 is extended (by others) to Wyndfields Boulevard, and Wyndfields Boulevard is extended (by others) southward from S.R. 56 to the project's northern boundary, so as to provide additional access to the project (other than Oldwoods Avenue, only). The developer therefore also shall have the option to contribute all or a portion of its proportionate share amount toward the construction of said Phase 2 off-site improvements, subject to mutual agreement by the County and the other constructing parties, for any portion of such improvements.

If any portion (or all of the proportionate-share payment is made under this option, the developer(s)/applicant(s) shall be entitled to impact fee credits against the proportionateshare payment actually made, in accordance with the Impact Fee Ordinance as amended.

INITIAL CERTIFICATE OF CAPACITY REQUIRED FOR D:' 'YEZONINGS, PRELIMINARY SITE PLANS, PREU' \RY PLANS, NON-RESIDENT\ _ SUBDIVISION, RESIDENTIAL SUBDIVISION INTO ARE THAN ONE DWELLING UNIT PER LOT, AND PUBLIC SCHOOL COMPREHENSIVE PLAN CONSISTENCY REVIEW To Be Completed By Department Responsible For Approval Sought: Completed Certificate Must Be Attached To the Agenda Item and Approval Document >ompleted Application Received On (Date): Certificate Form Completed By : 'arcel 1.0. #'s: See Attached (attach survey if project includes portion of parcel) _ 3oject IVame: Livingston Subdivision Name: TAZ No.: 245 TAZ Map Version: GIs Applicant Name, Address, and Telephone Number: clo Tew & Associates, 727-451-0615 Job Site Address: Project has direct connection (See 402.5.C.5.A.) to following collectorslarterials: Aggregated With Another Project?(See 402.5.C.5.B) Yes x No (If yes, identify project name and I.D. No. Prior building(s) on or after January 1, 1985? Yes x No (If yes, identify use and unitslsq. ft. 1 Approval Sought (Check all that apply): - DRI Non -Residential Subdivision Rezoning Residential Subdivision Into More Than One Dwelling Unit Per Lot - Preliminary Plan Public School Comprehensive Plan Consistency Review - Preliminary Site Plan TYPE OF DEVELOPMENT (Use TIS Exhibits for land use description and units of measurement and if not on Exhibits, use ITE land use codes and description) (If not restricted by applicant, use maximum allowed by requested (rezoning or DRI) or approved (other approvals) zoning or land use, whichever is les: Residential Nonresidential x Single Family 1240 Specific Use I - sq. ft. Mobile Home Park 1 - sq. ft. Congregate Care Facility 1 - (specify uni Apartments x Low-Rise CondoKownhome 540 Storage1 Display Area I - sq. ft. Hi-Rise Condominium (3 or more stories) Other Residential EXEMPTIONS AND LIMITED EXEMPTIONS (Re *EXEMPTIONS (See 402.6 and Concurrency Applicability): A. ALL FACILITIES Approved school consistency review or preliminarylconstruction plan prior to December 1,2006 Complete application prior to December I, 2006 (Apply old 402 and TIS Guidelines) Unexpired Certificate of Level of Service Compliance Unexpired DRI approved prior to April 9, 1991 6. ROADS ONLY Unexpired Initial Certificate of Capacity Unexpired DRI applied for or approved prior to December 1,2006 Unexpired Traffic Study Completed After June 4, 1999 Unexpired approved Traffic Study Methodology Prior to December 1, 2006 (Apply old TIS Guidelines) Unexpired approved Development Agreement exempt from transportation concurrency Exemption Expires On: Exemption Revoked On: uires ) *LIMITED EXEMPTIONS (See 402.7; requires signature from County Administrator or his designee): Public School or School Required for School Concurrency Governmental Building or Use Target Business (requires letter from PEDC) Employment Center Affordable Housing -.(requires. letter from -- Community Development) TNO Development Exemptions (check all that apply): Impact Fees o; lnterlocal Agreement As Proportionate Share (Roads Only) Traffic Study Waiver (Roads Only) 3 years committed capacity vs. 1 yr. (Roads Only) Extension of Certificate wlo Additional Reviel Other (requires CAO approval) ISSUANCE DATE: (Use date of final zoningldevelopment order approval) EXPIRATION (See 402.3.A.): All Facilities (other than roads): Certificate of Capacity Expires (or subject to additional review) On: Revoked On: Relinquished On: (6 yrs from issuance) Roads: Certificate of Capacity Expires (or subject to additional review) On: (GM to complete) Revoked On: Relinquished On: - *Completed Certificate of Capacity with limited exemptions or with exemptions for which no prior certificate of capacity has been issued must be distributed to the following: (1) Growth Management Administrator, (2) Engineering Services Director, (3) Parks and Recreation Director, (4) Transportation Manager, (5) Development Review Director, (6) MPO Transportation Planning Coordinator, (7) Assistant County Administrator for Development Services, (8) Assistant County Administrator for Utility Services, (9) OM6 Director, and (10) BOCC as a noted item on agenda (excluding (3) and (8) if exemption is for roads only).

CONCURRENCY REVIEW (To Be Completed by Department Listed Below Only; Leave Blank if a 402.6 Exemption Applies) Somp. Plan Elements Meets LOS Std. Review Standards Conditional Yes No Approval(attach conditions of approval.. or list?oads (Growth Management) IIIi LDC 402.5, Transportation Element 2.4.1 and TIS Guidelines tdatermater Supply (Utilities) I I LDC 402.4.A. and Public Facilities Element 1.I and 1.3 Sewer (Utilities) 0 El a LDC 402.4.A. and Public Facilities Element 3.1 ParksIRecreation (Parks) LDC 402.4.B. and Recreation and Open Space Element 1.I Solid Waste (Lltilities) E7 0 I LDC 402.4.A. and Public Facilities Element 4.1 Mass Transit (Public Transportation) I m LDC 402.4.A. and Transportation Element 5.1 Reviewed by: Title Date

A * INITIAL CERTIFICATE OF CAPACITY O{- 261 REQUIRED FOR DR1* 'IEZONINGS, PRELIMINARY SITE PLANS, PRELIM" '9RY PLANS, NON-RESIDENT1 LIBDIVISION, RESIDENTIAL SUBDIVISION INTO :E THAN ONE DWELLING UNIT PER Lb I. AND PUBLIC SCHOOL COMPREHENSIVE PLAN CUI\JSISTENCY REVIEW To Be Completed By Department Responsible For Approval Sought; Completed Certificate Must Be Attached To the Agenda Item and Approval Document ompleted Application Received On (Date): Certificate Form Completed By : arcel I.D. #'s: See Attached (attach survey if project includes portion of parcel) roject Name: Livinqston Subdivision Name: AZ No.: 245 TAZ Map Version: GIs,pplicant Name, Address, and Telephone Number: c/o Tew & Associates, 727-451-0615 ob Site Address: 'roject has direct connection (See 402.5.C.5.A.) to following collectorslarterials: iggregated With Another Project?(See 402.5.C.5.B) Yes x No (If yes, identify project name and I.D. No. 'rior building(s) on or after January 1, 19857 Yes x No (If yes, identify use and unitslsq. ft. ) Approval Sought (Check all that apply): - DRI Non -Residential Subdivision - x Rezoning Residential Subdivision Into More Than One Dwelling Unit Per Lot Preliminary Plan Public School Comprehensive Plan Consistency Review - Preliminary Site Plan TYPE OF DEVELOPMENT (Use TIS Exhibits for land use description and units of measurement and if not on Exhibits, use ITE land use codes and description) If not restricted by applicant, use maximum allowed by requested (rezoning or DRI) or approved (other approvals) zoning or land use, whichever is les: 7esidential Nonresidential x Single Family 1240 Specific Use 1 sq. ft. Mobile Home Park I - sq. ft. Congregate Care Facility - I - (specify uni Apartments x Low-Rise CondoiTownhome 540 Storage1 Display Area 1 - sq. ft. Hi-Rise Condominium (3 or more stories) Other Residential EXEMPTIONS AND LIMITED EXEMP'I'IONS *EXEMPTIONS (See 402.6 and Concurrency Applicability): A. ALL FACILITIES Approved school consistency review or preliminarylconstruction plan prior to December 1,2006 B. ROADS ONLY Complete application prior to December I, 2006 (Apply old 402 and TIS Guidelines) Unexpired Certificate of Level of Service Compliance Unexpired DRI approved prior to April 9, 1991 Unexpired Initial Certificate of Capacity Unexpired DRI applied for or approved prior to December 1,2006 Unexpired Traffic Study Completed Affer June 4, 1999 Unexpired approved Traffic Study Methodology Prior to December 1. 2006 (Apply old -1-1s Guidelines) Unexpired approved Development Agreement exempt from transportation concurrency Exemption Expires On: Exemption Revoked On: Authorized Growth Management Signature (Recuires ) *LIMITED EXEMPTIONS (See 402.7; requires signature from County Administrator or his designee): Public School or School Required for School Concurrency Governmental Building or Use Target Business (requires letter from PEDC) Employment Center Affordable Housing (requires letter from Community Development) TND Development Exemptions (check all that apply): Impact Fees or Interlocal Agreement As Proportionate Share (Roads Only) Traffic Study Waiver (Roads Only) 3 years committed capacity vs. 1 yr. (Roads Only) - Extension of Certificate w/o Additional Revie! - Other (requires CAO approval) ISSUANCE DATE: (Use date of final zoningldevelopment order approval) EXPIRATION (See 402.3.A.): All Fac~lities (other than roads): Certificate of Capacity Expires (or subject to additional review) On: Revoked On: - Relinquished On: (6 yrs from issuance) Roads Certificate of Capacity Expires (or subject to additional review) On: (GM to complete) Revoked On: Relinquished On: 'Completed Certificate of Capacity with limited exemptions or with exemptions for which no prior certificate of capacity has been issued must be distributed to the following: (1) Growth Management Administrator, (2) Engineering Services Director, (3) Parks and Recreation Director, (4) Transportation Manager, (5) Development Review Director, (6) MPO Transportation Planning Coordinator, (7) ~ssistant county Administrator for Development Services, (8) Assistant County Administraior for Utility Services, (9) OMB Director, and (10) BOCC as a noted item on agenda (excluding (3) and (8) if exemption is for roads only). -

CONCURRENCY REVIEW (To Be Completed by Department Listed Below Only; Leave Blank if a 402.6 Exemption Applies) Comp. Plan Elements Meets LOS Std. Review Standards Conditional Approval Yes No (attach conditions of approval or list below) Roads (Growth Management) WaterNVater Supply (Utilities) LDC 402.5, Transportation Element 2.4.1 and TIS Guidelines LDC 402.4.A. and Public Facilities Element 1.I and 1.3 Sewer (Lltilities) LDC 402.4.A. and Public Facilities Element 3.1 ParksIRecreation (Parks) Solid Waste (Utilities) Mass Transit (Public Transportation) LDC 402.4.B. and Recreation and Open Space Element 1.I LDC 402.4.A. and Public Facilities Element 4.1 LDC 402.4.A. and Transportatio,@lepent 5.1 : Reviewed by: Cindy A. Zatorski Lead Utilities ln'spector / / Development Review Tech I Title LIVINGSTON PID #'S 36-26-20-0030-06800-0000; 36-26-20-0030-06900-0000; 35-26-20-0000- 001 00-0000; 35-26-20-0000-001 00-0020 AND 36-26-20-001 0-02700-001 0 PCU #07-261.OO We have reviewed the referenced parcel and have determined that this parcel is within the existinglfuture areas where water, wastewater andlor solid waste service(s) may be provided by Pasco County Utilities. An Application for Service, per County codes and ordinances, for water, wastewater andlor solid waste service(s) to this property must be submitted and will be subject to the following conditions: The provision of water and wastewater services is contingent upon the County obtaining adequate water supply from Tampa Bay Water; receiving all the necessary permits and approvals to implement and construct the County's planned system improvements and facility expansions needed to serve the development; and the Developer's, and its successors or assigns, compliance with the conditions of Pasco County Code Chapters 46 and 11 0, (including but not limited to the obligation to execute and implement, as applicable, a Utility Services Agreement and a Master Utility Plan, both acceptable to the County, and,the payment of water andlor wastewater impact fees). Likely points of service connection to the County's existing water transmission and wastewater collection facilities may be located at significant distances and off-site of the project development area. Off-site facilities and any on-site facilities will be addressed, as applicable, through the development approval process and approval of a project specific Master Utility Plan (MUP). Furthermore, the County may, as a matter of standard utility service policy, require necessary line extensions by the developer in accordance with the provisions of a standard Utilities Service Agreement. This agreement must be executed between the County and OwnerlDeveloper prior to construction approval of the project. The provision of solid waste service is contingent upon the County receiving all permits and approvals necessary to implement and construct the County's planned disposal system improvements and facility expansions needed to serve the development; and the Developer's, and its successors or assigns, compliance with the conditions of Pasco County Code Chapter - r _. 90 and other applicable regulatory requirements.

INITIAL CERTIFICATE OF CAPACITY REQUIRED FOR D~~~PEZONINGS, PRELIMINARY SITE PLANS. PREL~' \IRY PLANS, NON-RESIDENl,,SUBDIVISION, RESIDENTIAL SUBDIVISION INTO _IRE THAN ONE DWELLING UNIT PER L~T, AND PUBLIC SCHOOL COMPREHENSIVE PLAN CONSISTENCY REVIEW To Be Completed By Department Responsible For Approval Sought; Completed Certificate Must Be Attached To the Agenda Item and Approval Document,"ompleted Application Received On (Date): Certificate Form Completed By : 'arcel I.D. #'s: See Attached (attach survey if project includes portion of parcel) Project Name: Livinqston Subdivision Name: TAZ No.: 245 TAZ Map Version: GIs Applicant Name, Address, and Telephone Number: c/o Tew & Associates. 727-451-0615 Job Site Address: Project has direct connection (See 402.5.C.5.A.) to following collectorslarterials: - -- - - Aggregated With Another Project?(See 402.5.C.5.B) Yes x No (If yes, identify project name and I.D. No. Prior building(s) on or after January 1,19851 Yes x No (If yes, identify use and unitslsq. ft. 1 Approval Sought (Check all that apply): - DRI Non -Residential Subdivision 2 Rezoning Residential Subdivision Into More Than One Dwelling Unit Per Lot - Preliminary Plan Public School Comprehensive Plan Consistency Review - Preliminary Site Plan TYPE OF DEVELOPMENT (Use TIS Exhibits for land use description and units of measurement and if not on Exhibits, use ITE land use codes and description) (If not restricted by applicant, use maximum allowed by requested (rezoning or DRI) or approved (other approvals) zoning or land use, whichever is les: Residential Nonresidential -- X Single Family 1240 Specific Use 1 - sq. ft. Mobile Home Park I - sq. ft. Congregate Care Facility 1 - (specify uni Apartments x Low-Rise Condo~Townhome 540 Storage1 Display Area 1 - sq. ft. Hi-Rise Condominium (3 or more stories) Other Residential EXEMPTIONS AND LIMITED EXEMPTIONS (Re *EXEMPTIONS (See 402.6 and Concurrency Applicability): A. ALL FACILITIES Approved school consistency review or preliminarylconstruction plan prior to December 1,2006 Complete application prior to December I, 2006 (Apply old 402 and TIS Guidelines) Unexpired Certificate of Level of Service Compliance Unexpired DRI approved prior to April 9, 1991 B. ROADS ONLY Unexpired Initial Certificate of Capacity Unexpired DRI applied for or approved prior to December 1,2006 Unexpired Traffic Study Completed After June 4, 1999 Unexpired approved Traffic Study Methodology Prior to December 1, 2006 (Apply old TIS Guidelines) Unexpired approved Development Agreement exempt from transportation concurrency Exemption Expires On: Exemption Revoked On: uires ) *LIMITED EXEMPTIONS (See 402.7; requires signature from County Administrator or his designee): Public School or School Required for School Concurrency Governmental Building or Use Target Business (requires letter from PEDC) Employment Center Affordable Housing (requires letter from Community Development) TND Development Exemptions (check all that apply): Impact Fees or Interlocal Agreement As Proportionate Share (Roads Only) Traffic Study Waiver (Roads Only) 3 years committed capacity vs. I yr. (Roads Only) Extension of Certificate wlo Additional Revie! Other (requires CAO approval) ISSUANCE DATE: Authorized Growth Management Signature (Use date of final zoningldevelopment order approval) EXPIRATION (See 402.3.A.): All Facilities (other than roads): Certificate of Capacity Expires (or subject to additional review) On: Revoked On: Relinquished On: (6 yrs from issuance) Roads: Certificate of Capacity Expires (or subject to additional review (GM ) On: to complete) Revoked On: - Relinquished On: *Completed Certificate of Capacity with limited exemptions or with exemptions for which no prior certificate of capacity has been issued must be distributed to the following: (1) Growth Management Administrator, (2) Engineering Services Director, (3) Parks and Recreation Director, (4) Transportation Manager, (5) Development Review Director, (6) MPO Transportation Planning Coordinator, (7) Assistant County Administrator for Development Services, (8) Assistant County Administrator for Utility Services, (9) OMB Director, and (10) BOCC as a noted item on agenda (excluding (3) and (8) if exemption is for roads only).

' \ CONCURRENCY REVIEW (To Be Completed by Department Listed Below Only; Leave Blank if a 402.6 Exemption Applies) amp. Plan Elements Meets LOS Std. Conditional Review Standards Yes No Approval(attach conditions of approval or list Toads (Growth Management) El I3 LDC 402.5, Transportation Element 2.4.1 and TIS Guidelines flatermater Supply (Utilities) I3 El 0 LDC 402.4.A. and Public Facilities Element 1.I and 1.3 Sewer (Utilities) El= El LDC 402.4.A. and Public Facilities Element 3.1 ParkslRecreation (Parks) El I3 0 LDC 402.4.B. and Recreation and Open Space Element 1.I Solid Waste (Utilities) El El I LDC 402.4.A. and Public Facilities Element 4.1 Mass Transit (Public Transportation) 0 ca/ LDC 402.4.A. and Transportation Element 5.1 Reviewed by: : I I.'. * Title Date