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•�1 <br /> y'Si9� <br /> _ = : PA��O ��UtVTl�9 �'LORIDA <br /> ,;�.: <br /> �. . <br /> Permit No. �� �� <br /> Date Permitted //— /z—/_�,� <br /> Builder Name/Owner Name I�/�'��C�j� j���' Control # <br /> County Parcel No, � �—Z(—�/ �. �b�00—0�D6- OOv�O SubDiv: �+ �(�P.�G�C�"Q <br /> AddresslLocation ��Zp p S�tQ� ,�j��{��� - ����j <br /> Classification/Type of Use /� � , � �� ��� <br /> TRAIVSPORTA'TION IMPACT FEE Rate: Sq Ft Unit: ���� <br /> Exempt � Yes � No How Determined <br /> Impact Fee Amount $ � � �� Zone No. TqZ; <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ �L�� �� � Z� <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes [] No How Determined <br /> PARKS AND RECREATIOIV FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ ���/.�j� <br /> Exempt � Yes � No How Determined <br /> LIBRARY �EE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT <br /> Prepared By , Checked By <br /> NO CER�IFICATE OF OCCUPANCY VIIILL BE ISSUED OR FINAL INSPECTIOfV <br /> PERFORMED UNTIL THE 70TAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence, but simply recelpt of a copy of this form,placing <br /> the building permft owner on notice of this assessment and thQ conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />