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—_------- <br /> �.� i <br />� I - <br /> � <br /> i ���J�� l.i�'L�!'� !�+� ����'�� <br /> I r <br /> ` Permit Na. � �� , <br /> � Date Permitted !l-t -/,� <br /> � Buiider Name/Owner Name �`IaY 11��� Gontrol# <br /> ' fl` Caunty Parcel No, ��{2-�-�- a(`IZO�-D(12d0'�/7?! SubDiv: �'! yt-`t�(71 _ I <br /> � <br /> ` AddresslLocatlon J ��� Ct,t-�'�6�'�S� �`���.. � <br /> � ClassificationlType of Use �/,�1 t� �r�rf <br /> 'fRANSPORTATiON iMPAC7 FEE Rate: Sq Ft Unit: �f 3�Z' <br /> Exempt ❑Yes ❑ No How peterm{ned <br /> ' impact Fee Amount $ ����" r Zone No. TAZ: <br /> SCHOOL IMPACT FEE � <br /> Account (056) Single-Family petached House Amaunt $ _ �, �? 7�•� <br /> (057} Mobile Home <br /> (058) Other Residentiai <br /> 123) Coilection Fee <br /> Exernpt [� Yes [� Na How Determined <br /> , PARKS AND RECREATIt?N FEE <br /> Land Account Land Credit tand Tatal <br /> Recreation Account Recreatian Credit Recreation Totai <br /> Zone T07AL AMQUNT $ �(�p`5� <br /> Exempt ❑Yes � No Haw Determined <br /> LIBRARY FEE <br /> Land Accaunt land Credit Land Total <br /> Facility Account Faci(ity Credtt Facility Totai <br /> Exempt ❑ Yes ❑.No How petermined Total Amount _��� <br /> RESOURCE FEE ERU <br /> T07AL AMdUNT <br /> Prepared By � Checked By <br /> � <br /> NO CERTIFICATE OF GICCUPANCY W►LL BE ISSUED OR FINAL{i�SPEGTi01� <br /> PEfiFORMED UNTIL THE TOTAL AMOUNTS LlSTED HAVE <br /> , BEEN RAID ARiD . <br /> i2ECE1P7ED fOR BY A CEN1'RAL PERMl1TtNG OFFiCE OF PASCO COUNiY <br /> Acknowledgement below does not Imply aoceptanes of concurrance,but simpty receipt af a copy of this fo�cn,placing <br /> the buHdfng parmft owner on notice of ihis assessment and tha oondit3ons of payment for same. <br /> DATE REGEIVEp BY <br /> �' RECEIPT NO. DA7E SY <br /> -. � <br />