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' : PA�C4 COUNTY, FLClRIDA <br />, <br />� <br />'�, Permlt No, l��77 <br /> date Permitted c„�=�7 . � <br /> Builder Name/Owner Name ���/Y� � Control# <br /> �Courity Parce!No. ����-0176-��Z�'�? BubDiv: ���/�n2,�5 <br /> Address/Location c.3 7ts�tj �J�[1 � �'I ��- <br /> � Classificationl�"ype of Use G�.�•� /�z'rF"� <br /> TRAN�PORTATION IMPACT FEE Rate: Sq.Ft Unit: Z���� <br /> � Exempf []Yes (� No Now Qetarmined <br /> � Impact Fee Amounf $ �j �3Z • Zona No. TAZ: <br /> SCHOOL lMPACT FEE L <br /> Account (056) Single-Family Detached House Amaunt $ _ G�� <br /> ' ' (Q57) Mobile Home <br /> (058} �tner Residentia( • - <br /> 123) Collection Fee <br /> Exempt [j Yes {� iVo � Haw Determined <br /> PARKS`AND RECREATION FEE � <br /> Land Account Land Credit land i'ota( <br /> � �Recreation Account Recreatian Credit Recreation Total <br /> � Zbne � TOTA�AMOUNT $ ��� �c� <br /> ! � Exempt []Yes ❑ No How Determined ' <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total � <br /> Faciiity Account Facility Credit Facilfty Totai i <br /> Exempt [�Yes ❑ No How petermined Tatal Amount � <br /> RESOURCE FEE ERU <br /> �� TOTAl.AMOUNT . <br /> i - � <br /> Prepared By Checked By <br /> NO CERTtFiCATE OF OCCUPANCY WtLL BE IS3UED C?R FINAL INSPECTiQN <br /> PERFORMED UNTlL TNE TOTA�AMOUNTS i.tSTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITI'ING OFFiCE OF PASCO COUNTY <br /> Acknowiedgemenk Below doas not Imply acceptance of cancurrence,but slmp{y receipt of a copy of this form,piacing <br /> � the building permlt owner on notice of this assessment and thQ conditions of payment for same. <br /> I � <br /> � <br /> � DATE , RECEIVED BY <br /> i <br /> I RECEIPT NO. DATE BY <br /> � <br /> � <br /> � —-- � <br /> i - <br /> I _ _ ..,__. _ � _�_ �.�.. .�. . . . <br /> � <br />