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;��� `` �,���CI COUNTY, �LORIDA <br /> ' � � � <br /> . .... Permlt No. /i�S�I�...—. <br />' Date Permitted ____�__^_.._ � <br /> �� �,in�Q �t�nGS ��nt�r l# ' � <br /> 8uilder Name/owner Name � <br /> County Parcel No.p3�-�- �bl�'1��'��`�� �ubDiv: � +i� I <br /> AddresslLacatlars ��1�I ��,` �� �� I <br /> Classification/Type of Use i�m�M1^`�rC i a.4� ��`� S�-'�� <br /> TRANSPORI'AT{t3N(MF'AGT FEE � Rate: Sq Ft Unit; j,�— <br /> Exempt (� Yes � No NoW Determined <br /> ' Impact Fee Amaunt $. D�7�•I�D Zone Na. � TP.Z: <br /> � � . . . <br /> SCNOOL IMPACT FEE <br /> Accaunt (058} Single-Family Detached House Artlottnt $ --�'��. ` <br /> ' (057) Mobile Name � . . <br /> (058) Other Rasiden#ial <br /> �23} Coilaction Fee I <br /> Exempt [� Yes [� R!o F3ow Defarmined <br /> �. I <br /> I PARKS AND REGR�AT(ON F�E� � <br /> � Land Accounk L nd Credit Land Total <br /> ' Recreat3on Account Recfeatian Credit Recreatlon Tatal <br /> Zone TOTAI.AMOUNT $ `� <br /> Exernpt ❑ Yes ❑ No N Iw Determined <br /> LIBRARY FEE <br /> Land Accoun# L (nd Credit Land Totat <br /> I Facility Account F�citjty C�edit Faoility Tota! <br /> i � <br /> , Exempt [� Yes ❑ Na Hiw Determined Total AmounE C� <br /> ' RESOURGE FEE I ERU � <br /> ' TOTALAMOUNT � <br /> � <br /> Prepared 8y � I _ cn����a�y <br /> I <br /> NO CERTiFICATE taF OCCiUPANCY WiLL BE 1SSUEb OR FINAL INSPECTIQN <br /> PEFtFORMED UNI ti.'FHE TOTAL AMt1t1NTS LISTER HAVE <br /> B�EN PAID ANp <br /> �I REC�IPTED FOR BY A CEN7RAL P6RMIT7ING O�FICE•OF PASCO COUNTY <br /> Acknowledgement below does not imply al ceptanae of concurrenae,huk slmply recelpt of e capy of thl�form,placing <br /> tha 6uilding perml#owne'r oi�na�ice of thls assassment and fhq conditions af paymant for same, <br /> I <br /> RATE I R�C�IVEf�BY <br /> RECEIPT NO. DATE BY <br /> I <br /> I <br /> � . _ . .. � , <br /> I <br /> I <br />