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. I <br /> ����� ������� ������� <br /> �� <br /> Permit No. B�� <br /> Date Permitted <br /> Builder Name/Owner Narrie � � � �j�LC <br /> Control# <br /> County Parcel No. D —Z —Z�—6D70„��(��.jQ f�� SubDiv: � �(/��27� <br /> Address/Locatlon ��p�� � <br /> �v�r�Q he <br /> Classification/Type of Use ,�f�'j� �� %'la/7�' <br /> TRANSPORTATION IMPACT FEE Rate: <br /> Sq Ft Unit: 3, /� <br /> Exempt [] Yes � No How Determined <br /> I Impact Fee Amount $ �j(p,3Z Zone No. <br /> TAZ: <br /> � SCHOOL IMPACT FEE <br /> I Account (056) Singie-Family Detached House Amount $ � �J�,� <br /> � (057) Mobile Home <br /> I (058) Other Resident(al <br /> 123) Collection Fee <br /> Exempt Yes � No How Determined <br /> PARKS AND RECREATIOfd FEE <br /> Land Account Land Credit <br /> Land Total <br /> Recreation Account ___ Recreation Credit <br /> � Recreation Total <br /> Zone � <br /> -- TOTAL AMOUNT $ '7�p�.� <br /> Exempt [] Yes � No Haw Determined <br /> I LIBRARY FEE <br /> Land Account Land Credit <br /> i Land Total <br /> Facility Account __ Facility Credit <br /> � Facility Total <br /> Exempt � Yes � No How Determined <br /> �_ Total Amount� <br /> RESOURCE FEE �— <br /> TOTALAMOUNT ERU <br /> Prepared By P Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED iINTIL THE TOTAL AMOUNTS LISTED HAVE <br /> RECEIPTED FOR BY A CENT ALEPEPtMl17'7'NG OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but stmply receipt of a copy of this form,placing <br /> the building permft owner on notice of thfs assessment and thq conditlons of payment for same. <br /> i DATE <br /> RECEIVED BY <br /> RECEIPT NO �_ pATE <br /> _�_ BY <br /> • .. <br /> � <br /> � �e--=.��.�.�a�.,�.-�.�.,._....._ <br /> i ------- <br /> � ,�:--T,__.—..--.:.�.__ R,.�-�,� <br />