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' _ � . i � , � � , PA�CO �OUI�TY; FLQRIDA I . � � i Petmit No. ��7� Date Permitted � Buiider Nameldwner Name �;(1 k`�,�-� L–,�t. C.Contral# I , �1 �� r" , Caunty Parcei No, (��-2�-2�.,.(?Z3?c�-U d t(X�`-Z�2�C7 SubDiv: � ,; AddresslLocation .� �� ! 5 c��te, ��t�� `, ClassificationlType of Use �S1 !�. TRANSPORTATION IMPAC'f FEE RaEe: Sq.Ft Unit: 2 3 � - �, Exempt ❑ Yes [� No How Determined :� tmpact Fee Amau�t $�� (o?a2. Zane No. TAZ: � � � � SCHOOL IMPACT FEE ' ' Account (056) Single-Famity Detached House Amc�unt $ ��,,�. � • `� (057) Mobile Home . ; (058) Qther Residentiai • � 123) Callectlon Fee � � Exempt [}Yes [] No � Haw�Determined ' , . , ' � � � __ ___�-___ � `� PARKS AND RECREATION FEE � Land Account Land Credit �Land Totat ' . , � � . ;�Recreation Accaunt Recreation Credit � Recreatian Totai _.__�_ _ _�— • '. Zbne � TOTAL AMOUNT $ �� '� Exempt ❑Yes ❑ Na How Determined � � � � L18RARY F�E �� Land Account Land Gredit � Land Total � ' Facility Account Facility Credit Facility Total �� �� Exampt [] Yes ❑ No Now Datermined To€al Amount `�-t� i �� RESOURCE FEE ERU - � T07AL AMOUNT . � I i � �.� - � Prepared By � Checked By � � � � ; NO CERTIFICATE OF OCCUPANGY WILL BE I$SUED OR FfNAL INSpECTiON � � PERFORMED UNTtG TF1E TOTAL AMOUNTS LlSTED HAVE i , �, BEEN PAID AtJt? � � RECElP7ED FOR BY A CENTRAL PERMITTiNG OFFICB OF PASCO COUN'I'Y �i ,' ' Acknowledgement below does not impiy acceptance of concurrence,but slmply recelpt of a copy of this farm,�1acing � the buitding permit owner on notice af this assessmant and ths conditions af payment for sama. i � � { ; DATE RECENEQ BY � �, RECEIPT NO. DATE 1 BY i I ' C -� . . .. 'I I