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���__—— --- - -- <br /> � • <br />� , . <br /> ' � PASC4 CtaUNTY, FL�RIDA <br /> . ,, <br /> , f <br /> 1�� 77 , <br /> � `� Permtt No. � <br /> , Date Permitted q z 9-l� "� <br /> I <br /> • Builder Name/Owner Name ��r ��°.�� Control# � <br /> County Parcei No. ,Zl�-Zlo-1.1�-13OQ0�000-p 3�0 SubDiv: �Y��_�r?�C,,��� ' <br /> � Addresst�ocatlon �1�5 /j'141�-r�Pi'1 �j�OG� ��e.- <br /> �� Glassificatfon/Type af Use �1� �_� 1�� ', <br /> � TRAiVSPORTATtON tMPACT FEE , Rate: Sq.Ft Unit: �, lX�� <br /> i <br /> Exempt (�Yes [] Rlo How Determined <br /> � ' impact Fee Amount $.�J�2 3 Z� Q� Zone No. TAZ: ' <br /> I � <br /> SCHOCIL tMPAGT F8E � <br /> Account (056) Stngte-Family Detached tiouse Amount $ ��7 rv.Z�i <br /> {057) Moblle Home <br /> (058) Other Resldsntiai <br /> 123) Coltection Fee � <br /> Exempt [(]Yes [�No How Determ(ned <br /> I <br /> PARKS AND RECREATION FEE �, �� <br /> , Land Account Land Credlt Land Totat <br /> I Recreation Account Recreatian Credit �Recreatian Totaf � <br /> I Zone TOTAL AM�lJNl' $ `7�a�: �"� <br /> � . . I <br /> Exempt �Yes ❑ No How Determinad ; <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Faciliry Account Facility Credit Facility Totai I <br /> � Exempt �Yes �] Na Fiaw Determined Total AmountGF.�" � <br /> i RESOURCEFEE ERU <br /> TOTAL AMOUNT' ' <br /> Prepared By ^ Checked By � <br /> ` <br /> NC1 CER71F{CATE OF OCCUPANCY WILL BE 1SSUED C1R FiNAI INSpEGTiON <br /> PERFORMED UN31L THE T07AL AMOUNTS LISTBD HAVE <br /> BEEN PA(D AND <br /> RECEtPTED FOR BY A GEN7FtAL PEftMITTINC�LIFFICE OF PASCO COUNTY <br /> Acknowiedgement betow does not!mply acceptance of concurrance,but simply recelpt of a copy of thfs form,piacing � <br /> the buifding permft owner on notics of thls assessment and thQ conditions of paymenk for same. i <br /> , <br /> DATE RECE{VED BY �� <br /> RECEIPT NO, DATE BY <br /> , , � <br /> . _ .. , <br />