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a . <br /> � .� PASC�J CC�Ut�TY, Fi.tJRIDA <br /> Permit No. ��� <br /> Date Permitted ���7 — ,- <br /> Builder Nair►s/Owner Name _L��,�,.... ��<s C(�..Control# <br /> .Courity Parcel No. D�`2b–L1�t.Y�?p..(�2�.�0 SubDiv: 'c,`�� �v�.rc�a <br /> AddresslLacation "3�[�`7 j �-,-.t`� �,;,,, ��.- <br /> .__c�r�i._ <br /> c <br /> Classification/Type of Use �i�q 2 ,�� C� ��2'�1Q�,�,,� <br /> �TRAN�PORTATION IMPACT FEE Rate: Sq Ft Unit: �D�_ <br /> - ;Exempt [� Yes (� No Now Determined <br /> � ,impaat Fee Amaunt $ �5! �3'�•�� Zone No, -�,c�, <br /> -----�._____ <br /> 'SCHpOL IMPACT FEE <br /> ;Account {056) Sing�e_Family pe#ached Hause Amount $ � !� 7/ Zg <br /> (057) Mobile Nome �+– <br /> (058} Qther Resfdentla! _ <br /> - 123} Co(lac#ion Fee <br /> :Exempt [�] Yes [] No � Haw�Determined <br /> iPARK3"AND RECR�ATION FEE <br /> I ;Land Account Land Credit �and Tatal <br /> � �:Recreation Account Recreation Credit . Recreatian Total <br /> � ,ZO�� TOTAL AMOUNT $ %�r.j�'. �5,6 <br /> :�xempt [�] Yes Q No How Determined ' � <br /> LIBRARY FEE <br /> Land A�caunt Land Credit Land TotaF � <br /> Facillty Account Facility Credit Facil�#y Totai <br /> ,Exempt [� Yes � No How Determined �` Total Amaunt <br /> --�.���� <br /> I RESOURCE FEE ERU <br /> .TOTAL•AMOUNT <br /> ' Prapared By �` ��.� Checked By <br /> –�.._� �—._. <br /> NO CERTIFiCATE OF OCCUPANCY WILL BE ISSUED OR FiNAL tNSPECTION <br /> PERFORMED UN71L THE TOTAL AMOUNTS LISTED HAVE <br /> RECEIFTEO FOR BY A CENTRAL P RM Ti'iNG OFFICE OF NASCO COUNTY <br /> Acknowiedgemenf below does not impiy acceptance of conourrence,but simply recelpt of a copy of this form,placing I <br /> the building permft owner on notice of this assessment and th�conditions of payment for same. <br /> DA7E RECEIVED BY <br /> RECEIPT NO. DATE gy <br /> , <br />