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i <br /> .;• <br /> ;� PASCO COUNTY, FLORIDA <br /> . .� . . <br /> �•` Permit No. C9�{1°I <br /> • Date Permi�ted <br /> Builder Name/Owner Name �� (,s�n�r I Control# ' , <br /> County Parcel IVo. 8a-a�o-a 1-C�OI C'�-f��gQO-CA)b SubDiv: <br /> I <br /> AddresslLocation (�-7�1 Q�a�U�`n �� — U n! � - �� <br /> Classiflcation/TyQe of Use S " , �� <br /> T�NSAORTATION IMFACT FEE � Rate: Sq Ft Unit; T_ <br /> Exempt ❑ Yes �No How Determined . <br /> ' Impact Fee Amount $.���;g,C3Z� Zone No. T�� <br /> SCHOOL IMPACT FEE ` � <br /> Account (056) Single-Famlly Detached House Amount $ <br /> (057) Moblle Home . <br /> (058) Othe�Resiclential <br /> 't2 ) Collection Fee <br /> Exempt �es �] Na How Determined <br /> .I. <br /> Pi4RKS�ND RECREATION FEE , <br /> Land Account Land Credit Lland Total <br /> Recreation Account Rec�eation Credit ( Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> ' Exempt ❑ Yes � No �iow Determi <br /> � <br /> LIBRARy FEE ' <br /> Land Account La d Credit � Land Total <br /> Facility Accounf FacilltY Cr Facility Total <br /> Exerppt ❑ Yes -❑ No How Determined I Tatal Amount <br /> � <br /> RESOURCE FEE ' ERI�, <br /> TOTALAMOUNT � � <br /> Prepared By Checked By <br /> . y0 CERTIFICATE OF OCCUFANCY WILL,BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS'LISTED HAVE <br /> BEEN PAID ANDI - <br /> RECEIPTED FOI�BY A CENTRAL PERMI7T�NG OFFICE•OF PASCO COUNTY � <br /> Acknowledgement below does not Imply acceptahce of concurre�ce,but simply recelpt of a copy of this form,placing <br /> the building pertnit owne�on notice of this assessment and thq cond(t(nns pf payment for same. <br /> DATE � RECEIVED BY <br /> RECEIPT NO. DATE BY ' <br />