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� <br /> � PQ►SCO COIJt�l"Y, FLORlDA <br /> Permit No. � 2 '- <br /> Date Permitted ---=_�'�� <br /> Builder Name/Owner Name ��� � Control# <br /> County Parcel No. - �Z -Ql(d- SubDiv: GC/�'/,�J��p�� <br /> Address/Location � 77�Z �i�a�)",� �� �� �'���' <br /> Classification/Type of Use ��riG�e �e,P.�C��°`C <br /> TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: �, 92� <br /> Exempt � Yes � No How Determined -- �- <br /> Impact Fee Amount $ u�,�3 2• � Zone No. TqZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ _ �]� <br /> (057) Mobile Home � � <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes � No How Determined <br /> PARK3 AND RECREATION FEE <br /> Land Account Land Credit Land Totai <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7�i�'/, �,� <br /> Exempt � Yes � No How Determined � <br /> LIBRARY FEE <br /> Land Account , Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> i <br /> Exempt � Yes �] No How Determined Total Amount`� I, <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT � <br /> Prepared By � Checked By <br /> NO CERTIFICATE OF OCCUP,4NCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> RECEIPTED FOR BY A CENT ALEPERMI ITTING OFFICE OF PASCO COUNN <br /> Acknowledgement below does not Imply acceptance of concurrence,but slmply recelpt of a copy of this form,placing I <br /> lhe buflding permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE <br /> RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> `�---r-���.----z�� _��-_-�- --.�,._�.��,_r__w-_ — --T-- <br />