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i , <br />� . � � � � <br /> PA�CO COUNTY, FLORIDA <br /> . . <br /> Permit No. - l8�j?� <br /> Date Permitfed � _ ,. ' <br /> ' uilder Name/Owner Name � � ' <br /> ,� � Control# � <br /> � � ounty Parcel No. (��Q _.]/_/�j,n7o ���,���v� SubDiv: cSi`U� I <br /> ddress/Location �rf� j��� ��,��T I <br /> ilassification/Type of Use s�%� �� s��� <br /> TRAN�PORTATION IMPACT FEE Rate: <br /> , Sq.Ft Unit: _ , 3�n � <br /> • ,�xempt � Yes [] No How Determined <br /> � ;impact Fee Amount _$ ,3� �,3Z,�� Zone No. <br /> .�_ TAZ: i <br /> � 'SCHOOL IMPACT FEE '' <br /> ;Account (056) Single-Family Detached House Amount $ B 76, � I <br /> (057) Mobile Home � <br /> " (058) Other Residential . <br /> ' I 123) Collection Fee i <br /> iExempt [� Yes Q No � How�Defermined � <br />' �PARKSAND RECREATION FEE <br /> :Land Account Land Credit Land Total <br /> . � ��Recreation Account <br /> ,, - �_ Recreation Credit � Recreation Total � <br /> . �Zone TOTAL AMOUNT $ 7 p S <br /> -. �' � �a7 ` � I <br /> Exempt � Yes � No How Determined - <br /> �LIBRARY FEE <br /> ,L;and Account Land Credit ' <br /> �� Land Total ' ' <br /> � <br /> Facility Account Facility Credit � <br /> Facility Total <br /> �xempt � Yes � No How Determfned - <br /> '� �_ Total Amount �_ <br /> I�ESOURCE FEE - <br /> - IOTAL AMOUNT ERU <br /> I - <br /> Irepared By Checked By �� <br /> i <br /> � NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL qIVIOUNTS LISTED HAVE <br /> RECEIPTED FOR BY A CENTRAL P RMI T1'ING OFFICE OF PASCO COUNTY <br /> , <br /> I ' <br /> Acknowledgement below does not Imply acceptance of concurrence,6ut simply recelpt of a copy of this form,placing <br /> the buildfng permlt owner on notice of this assessment and thQ conditions of payment for same. <br /> ' i <br /> D�4TE <br /> i RECEIVED BY <br /> R�CEIPT NO. DATE �_ gY <br /> , � --- <br /> i , <br /> . i . <br /> � • � - .. , � <br /> , � <br /> , j � <br /> �=�-�:-�—�---� _ <br />