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i <br /> --- - ----" } <br /> f, <br /> h <br /> � � PASCA COUNTY, FLtaRtDA � <br /> � � � ,.. <br /> . � <br /> � � Permit No. �� � <br /> f Date Permitted ^-2(�-('7 i <br /> ------�--T— b <br /> k r'�� � <br /> Builder Name/Owner Name F�2.y�,v�c„r' S�c.... Contcol# � <br /> i <br /> Caunty Parce!No. (`7�-2�r 2�(-�07[�-.h02oa-O(3o �ubDiv: �i ��_� g <br /> Addressl�ocation ��eU c�� Sy�.� (C�.tt�� `��t�,-- � <br /> ClassificatfoniType of Use �e '�,-�t�v�.� I.CT �tt'1`/'V`� � <br /> .F � � <br /> ?RANSPORTATION tMPACT FEE , Rate: Sq.Ft Unit: 2 � <br /> 5 <br /> Exempt �Yes � No How Datermined ; <br /> � impact Fee Amount $�� �o c32 - Zone Na. TAZ: � <br /> SCHOOL IINPACT FEE � <br /> ACCOUn� (056} Singte-Family Detached House Amaunt $ 8�� � 2� <br /> (057} Mobile Home <br /> (058) Other Residentiai <br /> 128) Collect{an Fee <br /> Exempt [� Yes ❑ No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Accounf Land Credit Land Total <br /> Recreatian Account Recreation Gredit Recreatian Total <br /> Zane TOTAL AMpUNT $� � ��t��, � <br /> Exeinpt ❑Yes [] No Npw Determined <br /> LtBRARY FEE <br /> Land Account �and Credit Land Total <br /> Facility Account Facilify Credit Facifity Totai � <br /> Exempt (� Yes ❑ No Haw Determined Total Amount ��' !� <br /> RE30tlRCE FEE ERU ! <br /> 70TAL AMOUNT � ; <br /> Prepared By . Checked By <br /> NC1 CERTtFtCATE OF OCCUNANCY WILl.BE lSSUED t�R FINAL INSPECTION <br /> PERPORMED UNTIL THE 70TAL AMOUN7S LISTEQ HAVE <br /> BEEN PAid AND <br /> RECEtPTED FOR SY A CENTRAL PERMITI'tNG OFFiCE OF PASCi)COUN'tY <br /> Acknowledgement below does not lmpky aceeptance of concurrencs,but simpty recelpt of a copy of thls form,ptac{ng <br /> the buiiding permit owner on notice of thls assessmant and tha conditlons of payment for sama. <br /> DRTE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> _ � <br />