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� <br /> ' � PASCt� CCIUNTY, FL{�RIDA <br /> ` .. Permlt No. � <br /> Date Permittad � <br /> Buiider NamelOwner Name 1..�/1 Y"1Q�r'` �r�'� Gontroi# � <br /> i <br /> � <br /> I , - � <br /> I� .Caunty Parcei No. (��2�-1iC������DZCX��j}((3� SubDiv: �1 � +" <br /> �� Address/Loca#ian ��P Q 7 t� ��r'� l/t.�t t � '�-�'v`�- i <br /> j 'CtassificatlonlType af Use 1�.QsSt,�.n'�-�t� -st �� `�,m�l ��, <br /> TRAN�pORTATiC1t11MPACT FEE . Rate: Sq Ft Unit: G'��� � <br /> � ;Exempt �Yes [] No How Determined � <br /> �I i <br /> Impact Fee Amaunt $ ���23�• Zone No. TAZ: , <br /> , ;SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ �, 8'�� � � <br /> ' (05T) Mobile Home <br /> (058) Other Resid�ntial - <br /> 123} Caileotion Fee � ' <br /> � ;Exempt [� Yes [� No � Fiow Determined <br /> ;PARKS'AND RECREATiON FEE <br /> �Land Account Land Credit Land 7otal <br /> � °Recreation Account Recreation Credit Recreation Tota1 �� <br /> �' - Zbne TOTAL AMOUNT $ rI�v.�'�b � <br /> . I <br /> Exempt � Yes [� Na Haw Determ(ned � <br /> 'LlBRARY FEE ' <br /> �tand Account Land Credit Land Tota! � � <br /> Facility Accaunt Facility Credit Facility Total � <br /> � Exempt ❑ Yes ❑ No How Determined Totai Amount �-!' ` <br /> RESOURCE FEE ERU <br /> - .T07A1 AMOUNT � ' _ � <br /> , Prepared By Checked By <br /> NO CERT(FtCATE OF OCCUPANCY VIIILL BE{S3UED C)R FiNAL iNSPECTION i <br /> PERFORMED UNTIL 7NE 7'07A�AMOUNTS LISTED HAVE I <br /> BEEN PAIQ AND '� <br /> � � RECEIPTED FtZR BY A CENTRAL PERMI'RINa OFFlCE OF PASGQ COUNTY <br /> Acknowiedgement below does not imply acceptance of concurrence,but slmply recefpt of a capy of thts form,piacing I <br /> the building permlt owner on notice of this assessment and thQ conditions of payment for same. <br /> DATE RECEIVEQ BY <br /> RECEIPT NO. QATE BY <br /> � <br />