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� • 7 �� ; PASCO �OUN1'Y, �FLt�R1�A, <br /> � " � Permlt No. l ��p T <br /> Date Permitted ,�Tv� <br /> Buiider Name/Owner Name (,IJ�'C�1��Ct�t�'C Gontrol# <br /> County Parcel No. �,tr�(a-2(- �d L��l�^ 4 SubDtv: �����_���J}'� <br /> AddresstLocatlon J� 7/�'}�� �rR��E'- ,�� � <br /> GtassificatloM'ype oP Use �L11-tJ�'��� <br /> TRANSPQRTATtON IMPACT FEE � Rate: Sq.Ft Un1t: ���� <br /> Exempt [�Yes ❑ No Ho�r Determined <br /> ' Impact Fee Amount $. �Jr�a�Z � Zane fVo. TA2: <br /> SCHOOL IMPACT FEE � / <br /> Account (05�) Stngle-Family Detached House Amount $ /�" <br /> , (057) Mo63te tiome <br /> {058) Other Restdential <br /> 123) Coitection Fae <br /> Exempt [�Yes [�Na FCow Determtned <br /> PARKS AEtD RECREATION FEE <br /> land Account Land Credit Land Totat <br /> Recreation Accaunt Recreatian Credit �Recreation Tatal <br /> Zone TOTAL AMOUNT $ �tp`�-S� <br /> Exempt []Yes [� tJo How Determfned <br /> LtBRARY FEE <br /> Land Rccount land Credit Land Total <br /> Facitity Account Facility Credit Faci{ity Totai <br /> Exempt ❑Yes ❑ Na How Determined Tatat Amount� ; <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT ' <br /> s <br /> Pcepared By Checked By . <br /> . ; <br /> NO CERTIFtCATE OF 4GCtlPANCY WiLL BE ISSUED OR FiNAL INSPECT{C}N ; <br /> P�RFORMED UNTtL THE TOTAt,AMOUNTS�1STED HAVE � <br /> - BEEN PA►ID ANQ ; <br /> � 6tEGEfPTED FOR BY A CENTRA�PERMITTIIVG O�FtCH-OF PASCO COtlNTY � <br /> 1 <br /> S <br /> i Acknowledgement betow does not lmply acceptance of concurranae,but simply recelpt of a copy of this form,placing � <br /> �� the butiding psrmit owner on notfce of thia assessment and the coodltions of payment far same. <br /> ' i <br /> DATE RECE{VED BY <br /> k <br /> RECEIPT NO. DATE BY ; <br /> , { <br /> , <br /> t <br /> � � . . . .. ' �j <br /> � <br /> s��__ ��� _.________ <br />