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1 i <br /> . ; <br /> . • ; i <br /> -. i PASCO COUNTY, FLORID ' <br /> ; A <br /> � <br /> , , <br /> i , <br /> ; Permit No, - �Q�� <br /> j ,(�I Date Permftted ��-� <br /> Builder Name/Owner Name 17�1M �61.��0,. �� �� <br /> C0�'ri��kG'��y►Control# <br /> 1 Counry Parcel No. 03--Z6-21– 613p�bpdVO d <br /> ; 3! I SubDiv: 2 �� <br /> i Address/Location �377 6 c� <br /> '��Ur� ��;�� <br /> j Classificatfon/Type of Use �,���� ��� ' <br /> i TRANSPORTATION IMPACT FEE , Rate: C.� <br /> � Sq.Ft Unit: �����►�_�f g� <br /> Exempt [] Yes [] No How Determined � <br /> � Impact Fee Amount $. ' , � 3� <br /> Zone No, — T�: <br /> SCHOOL IMPACT FEE �-- <br /> Account (056) Single-Family Detached House Amount $ '2 B <br /> (057) Mobile Home _z "���c�.3 <br /> (058) Other Residential <br /> �123) Collection Fee <br /> Exempt Yes Q No How Determ(ned <br /> PARKS AND RECREATION FEE <br /> Land Account <br /> Land Credlt `_ Land Total <br /> Recreation Account <br /> � Recreation Credit <br /> Zone —��Recreation Total �_ <br /> � TOTAL AMOUNT $5`73, �� <br /> Exempt � Yes � No How Determined � <br /> LIBRqRY FEE <br /> Land Account <br /> Land Credit <br /> Facility Account Land Total <br /> �_ Facility Credit • <br /> Facility Total <br /> Exempt Yes <br /> ❑ ❑ No How Determined <br /> RESOURCE FEE �— Total Amoun�_ <br /> TOTALAMOUNT ERU <br /> Prepared By <br /> Checked By <br /> NO CERTIFICATE OF OCCUPANCY WIL�gE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMpUNTS LISTED HAVE <br /> RECEIPTED FOR BY q CENTRAL ERMIT'f NG OFFICE OF PqSCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply recefpt of a co <br /> the buliding perm�t owner on nodce of this assessment and th�conditions of a <br /> py of this form,placing � <br /> � P Yment for same. , <br /> DATE <br /> RECEIVED BY ' <br /> RECEIPT NO. — pATE <br /> _� BY <br />