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PASCO COUNTY, �LORIDA <br /> Permit No. �1911 U ( <br />� Date Permitted //�Z_�� <br /> Builder Name/Owner Name �p/�tvrCC�- ��g� Control# <br /> County Parcel No. �S� 2(,-Z/_�j p�o„��3d p � �- (,.,,__,�II <br /> ��p SubDiv: �W�t 2 <br /> Address/Location (e� ��,� ����` �� <br /> Classification/Type of Use �;r�q �� ���� <br /> � <br /> TRANSPORTATION IMPACT FEE . Rate: <br /> Sq.Ft Unit: �, d� <br /> Exempt � Yes [� No How Determined �— <br /> � Impact Fee Amount $, 3r�� Zone No. <br /> — __ TAZ: <br /> SCHOOL INiPqCT FEE <br /> Account (056) Single-Family Detached House Amount $ � � '�(o, Z� <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes � No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit <br /> Land Total <br /> Recreation Account �_ Recreation Credit <br /> __ Recreation Total <br /> Zone --- <br /> -- TOTAL AMOUNT $ ?(�9 S� <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit <br /> Land Total <br /> Facility Account __ Facility Credit � <br /> Facility Total <br /> Exempt � Yes � No How Determined <br /> __ Total Amou� <br /> RESOURCE FEE <br /> TOTALAMOUNT ERU <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE I <br /> RECEIPTED FOR BY A CENTRAL E MIT7'NG OFFICE.OF PASCO COUNTY I, <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply recelpt of a copy of this form,placing I <br /> the building permit owner on notice of this assessment and the conditions of payment for same. I <br /> DATE <br /> RECEIVED BY <br /> RECEIPT NO. __ pATE <br /> �_ BY <br />