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., . <br /> t s � ��'1s��l�A ����tl i �g F��,/R��d� <br /> �` <br /> .' ,. Permit No. � ��i� <br /> � Date Permitted - -- � <br /> ,. <br /> Builder NameiOwner Name ���� � �. Contral# <br /> County Parcei Na. --�-�- (��- ���' �l3 SubDiv: � �'!Lt.� ' f�� <br /> Address/Locatian � ��z-� `�'�'"a-t�i�. �C.(,��2. �� � '� l� �cJ`^ <br /> Classificatiantfype of Use i ��G{�(� �!�'�`�- <br /> TRANSPORTA'TiOT� IMPACT FEE Rate: Sq Ft Uni#: � � Io � � <br /> Exempt ❑ Yes [� No How Determined <br /> ' lmpact�ee Amaunt $ �l `C�O� Zone Na. TAZ: <br /> SCHODL IIyPACT FEE <br /> Account (Q56) Single-Family Detached House Amount $ �� <br /> (057) Mobile Home <br /> {058) Q#her Residentia! <br /> 123) Coltection Fee <br /> Exempt [�] Yes ❑ No How Determ(ned <br /> PARK� AND RECREA71�'?N FEE <br /> Land Accaunt Land Gredit Land Totai <br /> Recreation Accaunt Recreation Credit Recreatian Tatai <br /> Zone Tt3TAl.AMOUNT $ ���: �,� <br /> Exempt [] Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account �and Credit Land Tota! <br /> Facifity Account Faciiity Credit Facility Tatai <br /> Exempt � Yes ❑ No How DeEermined Total Arnount �� <br /> RES4URC� �EE ERU <br /> TQTAL AMOUNT � <br /> Prepared By Checked By � <br /> R�C} CERI"IPlCATE OF t�CCUPAPICX WILf. �E tSSUED t3R FINAL It�SPE�CTION <br /> PERFORMED UMTl�THE TOTAL�MqUR�TS USTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING O�F'!CE O� PASCO COUNTY <br /> Acknowledgement be(ow does not imply acceptance of conaurrence,but simpiy receipt of a copy ofi fhis form,plactng <br /> !he building permft owner an natfce of this assessment and th�condltions of payment for same. <br /> DATE RECE{VED BY <br /> RECEIPT NO. DATE BY <br />