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�—_.. <br /> :� � '•, <br /> � ._� - :. PASC� �O�1N`InY, �LORID,�A <br /> : <br /> �� . <br /> Permit No. � <br /> Date Permitted � <br /> uilder Name/Owner Name �.J � `�jy� ��G Control# <br /> �ounty Parcel No. �j�-7.�- ..�j �/ <br /> �� 17 70--���� /� SubDiv: S� �(1eY-�c(,[6 <br /> Address/Location � �3Z ��.✓'Y)� h� � <br /> Classification/Type of Use /� �,�, , ' , <br /> TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: �,,,3�p� <br /> Exempt � Yes �] fVo H Determined <br /> Impact Fee Amount $ � Zone No. 1-„qZ; � <br /> �CHOOL IMPACT F <br /> Account (056) Single-Family Detached House Amount $ B7d� Z,b <br /> (057) Mobile Home - <br /> (058) Other Residential � <br /> , 123) Collection.Fee , <br /> �xempt Yes [� No - How Determined <br /> PARKS AND RECREATION FEE <br /> �and Account Land Credit Land Total <br /> II <br /> Recreation Account Recreation Credit Recreation Total <br /> � <br /> Zone TOTAL AMOUNT $ � � �,6 <br /> Exempt [� Yes � No How Determined <br /> 418RAI3Y FEE <br /> Land Account Land Credit Land Totai <br /> acility Account Facility Credit Facility Total <br /> i <br /> Exempt [] Yes �Ale— oW eterm Total Amount�� <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT ` �� <br /> � <br /> F'repared By Checked By <br /> P10 CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIOfV <br /> PERFORMED UMTIL THE 70TAL AMOIJNTS LISTED HAVE <br /> � �EEN RAID ARID <br /> RECEIPTED FOR BY A CEIdTR�4L PERMlTTI(VG OFFOCE OF PASCO COUNTY <br /> cknowledgement below does not imply acceptance of concurrence, but sfmply recelpt of a copy of this form, placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE <br /> RECEIVED BY <br /> RECEIPT NO. DATE gY <br /> �---_—:�.. ._ ---- <br />