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f <br /> , � : �A�co c�u�-rY, FLaRiDA <br /> , . ' Permit No. 1r6�7� � <br /> . - � Date Petmitted 7—(�1'� - �'• <br /> � , i <br /> Builder NamelQwner Name���ll���� Contcol# � <br /> .CourityParcelNo. (�`�2twZ>2(t�'-tx.Ll'�P--b3�� SubDiv: ��t-i�.,i—�.rt12� �' <br /> i <br /> AddressJLocatlon ,�?74� , t`"Y'r�r�E'_ �� l-� '' <br /> 'Classi�cationffype af Use "�(�,�^�n�l.t�. I, <br /> �TRANSPORTAi'ION IMPACT�FEE Rate: Sq.Ft Unit: �t �7Z. � <br /> � �Exempt �Yes ❑ No How Determined I <br /> p �32- Zone No. TAZ: � <br /> � Im act Fee Amount $ ��� � <br /> SCHOOL IMPACT FEE . '� <br /> Account {056) Single-Family Detached House Amaunt $ � . ' <br /> � (057) Moblte Home f <br /> (058) Other Residential • • '� <br /> 123) Callectfon Fee i • � <br /> :Exempt [�]Yes [� iVo � How-Defermtned � <br /> ' ;PARKS AND RECR�A'FION FEE I <br /> ;Land Account Land Credit Land Tota1 � � � <br /> - ; <br /> � ��Recreatian Account Recreatian Credit ,�__�____ Recreation Total �; <br /> 'Zone •� TOTAL AM(?UN7 $ "7�.�.�5� ` <br /> �,Exempt (�Yes [] No How Determined � <br /> . , <br /> LIBRARY FE8 � <br /> i.and Account Land Credit Land Tota! � _ � <br /> Facility Account Feciiity Credit Facility Tatal � <br /> . . � <br /> Exeinpt [� Yes ❑ tVo How Determfned Totai Amount <br /> RESOURCE FEE ERU , <br /> � :'TOTAL-AMOUN7 ' � .. <br /> Prepared By � ` Checked By �� <br /> I <br /> NCJ CERTlFICATE OF OCCUPANCY WILL BE{SSUED OR FINAL INSPECTlON '� <br /> PERFORMED UNTlL THE TOTAL AMOUN'i'S LISTED HAVE <br /> BEEN PAIA AND ', <br /> � RECEIPTED FOR BY A CEN"TRpL PERMlTTtNG t3FFiCE OF PASCO GOUNTY , <br /> i <br /> Acknowiedgement below does nat Imply acceptance of concurrence,but slmpty recalpt of a copy of thls farm,pSacing � <br /> the buiiding peRnit owner on nottce oi this assessment and tha condffions of payment for same. , <br /> pATE RECEfVED BY <br /> RECEIPT Ni�. DATE BY � <br /> �I , . <br />