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� �i . i .: <br /> . I <br /> PASCO CQUNTY' FLO � <br /> � <br /> � RIDA , <br /> I , . .. � P��3� <br /> Permit No. <br /> � Date Permitted <br /> � Builder Name/Owner Name .��1�lt��� <br /> es{ �'-c�ontrol# <br /> County Parcel No. (��_ �/ �f,�7� ��2� ."� � � � <br /> D/�SubDiv: � <br /> I .ddress/Location � <br /> ���G/2 Z�' <br /> �G <br /> IClassification/Type of Use S'�� ` <br /> < <br /> �RANSPORTATION IMPACT�FEE . Rate: '/ <br /> Sq Ft Unit: 2i� 7� <br /> I xempt [] Yes [� No How Determined <br /> i mpact Fee Amount $ 3�(032�(� Zone No. � <br /> — __ TAZ: <br /> SCHOOL IMPACT FEE <br /> ccount (056) S(ngle-Family Detached House Amount $ i <br /> (057) Mobile Home <br /> (058) Other Residential �' � <br /> ' 123) Collection Fee <br /> � �Exempt [� Yes Q No � How�Determfned � <br /> � <br /> ' PARKSAND RECREATION FEE <br /> . I <br /> �and'Account Land Credit �Land Total � <br /> . � �� ecreation Account �_ Recreatfon Credit � <br /> __ Recreation Total _�_ <br /> • I I one TOTAL AMOUNT $ 7�a j•�j,6 i <br /> I �xempt � Yes � No , How Determined • .. <br /> IBRARY FEE . <br /> and Account Land Credit ' � , i <br /> Land Total � <br /> aciliry Account Facillty Credit � � <br /> Facil(ty Total � <br /> i <br /> Exempt � Yes � No How Determined - <br /> '.� �_ Total Amount <br />' ��tESOURCE FEE <br /> - TOTAL•AMOUNT ERU <br /> I� ... <br /> repared By `- <br /> Checked By I.� <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION � <br /> ' PHRFORMED UNTIL THE T07AL AMpUN'fS LISTED HAVE <br /> ' BEEN PAID ANp � <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY � <br /> pcknowledgement below does not Imply acceptance of concurrence;but simply recelpt of a copy of this form, lacing <br /> I the bullding pertnit owner on notice of thls assessment and thq conditlons of payment for same. <br /> � <br /> � . � <br /> DATE i <br /> I RECEIVED BY <br /> ECEIPT NO. �_ pATE �_I BY I <br /> � � . ,, i <br /> � <br /> �-�.m.__ <br />