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. � i ' <br /> ' �i <br /> .: PASCO C.OUNTY, FLORIDA <br /> : Permit No. � �j2�3Z <br /> ; Date Permitted �- (� <br /> uilder Name/Owner Name �eh,✓1�I,Y- ��5��(' Control# <br /> , ountyParcelNo, p�-��Z�- p0�0-ODZoo-D•Q�p SubDiv: c�r`��p <br /> ' ddress/Location `3(� �Z.� �.��� �, ��� �� <br /> ' lassification/type of Use o�'i�Gi �2 -�a,►,t, �t� �t� <br /> RANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2� 3'7� <br /> � xempt � Yes � No How Determined <br /> mpact Fee Amount _$3,(3 2, � Zone No. T,qZ; <br /> CHOOL IMPACT FEE <br /> � ccount (056) Singte-Family Detached House Amount $ _ � � 76, Z�_ <br /> ' � (057) Mobfle Home . <br /> , j (058) Other Residential . <br /> - 123) Collection Fee <br /> ; xempt [� Yes Q No How�Determined <br /> • ARKS AND RECREATION FEE <br /> and Account Land Credit Land Total <br /> ' � • ecreation Account Recreation Credit Recreation Total <br /> ; •, one TOTAL AMOUNT $ ��9•S�_ <br /> ; xempt � Yes � No How Determined ' � <br /> �IBRARY FEE <br /> and Account Land Credit Land Total � <br /> � acility Account Faciliry Credit Facility Total <br /> xempt � Yes � No How Determined Total Ariiount <br /> ESOURCE FEE ERU <br /> - .. OTAL AMOUNT <br /> repared By � Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORNIED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> RECEIPTED FOR BY A CENTRALE E MITT NG OFFICE.OF PASCO COUNTY <br /> � cknowledgement below does not Imply acceptance of concurrence,but simply receipt of a copy of this form,plaaing <br /> the buflding permit owner on notice of this assessment and the conditions of payment for same. <br /> ATE RECEIVED BY <br /> ECEIPT NO. __ DATE gy <br /> � <br />