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� � PASCO CQUNTY, FLORIDA <br /> � �� �� Permit No, _l c.50 <br /> Date Permitted ,�'=��-!"7 . •� <br /> Buiider NameiOwner Name ���G9'l��C_�Qy7�1�P�,�.Control# <br /> .Caunty Parcel No.���-�l?a—�'Y�.:��9� SubDiv: ����j`�Yi�2g� <br /> P+ddresslLocation c� 7�OlZ �pr�r yf� �O��`/a <br /> GlassificationCfype af Use �1�3�f� ���- <br /> TRANSPORTATiON IMPACT FEE Rate: Sq.Ft Unit: �,7`r� <br /> � • Exempf []Yes [] No How Determinsd <br /> Impact Fee Amount $ c3�• C�� Zone No. TAZ: <br /> SCNOt?L tMPACT FEE <br /> Accoun# (056} Single-Family Detached House Amount $ � _. <br /> ` (057} Mobite Nome _ <br /> (058} Other Residential • • <br /> 123) Collectlon Fee <br /> Exempt (� Yes [}No � How�Qetermined <br /> ' PARKS�AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> - �Recreation Account Recreation Credit Recreation 7ota! <br /> _ Zbne TQTAL AMQUNT $�7�3� ��. <br /> � Exempt [� Yes [] No liow Determined ' <br /> L.IBRARY FEE <br /> Land A�coun# Land Credit l.and Total � <br /> Facility Account Facility Credit Facillty 7ota{ <br /> Exeinpt � Yes [] Na How Determined Total Amaue�t ��_ <br /> RESOtlRCE FEE ERU <br /> • :TOTAI AMOUNT ' <br /> Prepared By Checked By <br /> NO CER'FlFtCATE OF OCCt3PANCY WiLL BE iSSUED OR FINAL 1NSPECTION <br /> PEF2FOF2MED UNTiL TNE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAtD AND <br /> � RECEIPTED FOR BY�A CENTRAL PERMITI'ING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptanae of concurrence,but simply recelpt of a capy of thfs form,piacing <br /> tha building permlt owner on notice of this assessment and the condltions of payment for sams. <br /> , pATE RECE{VED BY <br /> RECEIPT NO. DATE BY <br /> . _ . .. <br /> I <br />