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_ _. <br /> . ' _ i� � <br /> , � � ' : PASC4 ��Ut�TY, �Lt�R��A <br /> Permtt No. <br /> Q� <br /> Date Perm{tte �j�7.�j� <br /> Builder NamelOvrnar Name /��i�v�"�'tp�'+'tf��,�-' Control# <br /> County Paccei No. 2-��„� .»�?CX�(Z Q��-It�v`�Z7 SubDiv: �Nt�GiP�,l�V�� <br /> AddressJl.ocation ,"3 ��1 2- i�.(I+�G�L/t2�ti. �Zl�ldC.t� � <br /> (1 � <br /> Glassiflcatfon(fype of Use S`�Q�� `1t�snE ��( <br /> ���� <br /> TRANSAOFtTATtON 1MPACT FEE Rate: Sq.Ft Unit: 2,��Z(o <br /> Exempt �Yes [� No Ho�r Determined <br /> � impact Fee Amou�t $. �:�32� Zone No. TAZ: <br /> I SCHOOL IMPA6T FEE <br /> Accaunt (056} Single-Famlty petached House Amount $ '���'�(o• � � <br /> (057) Mobils Hame <br /> - {058) Other Resfdentiai <br /> 123) Gollectfan Fee <br /> I Exempt (�Yes Q No How peterm(ned <br /> PARKS AND RECREATION FEE <br /> Land Account Land C�edit �and Totai <br /> Recreation Account Recreatian Credit �Reareation Total <br /> Zone TOTAL AM(JUNT $ �(eq-S6 <br /> Exempt ❑Yas ❑ No Now Detarmfned <br /> � LIBRARY FEE <br /> � , Land Accaunt Land Credit Land Total <br /> F.acility Account Facil{ty Cred[t Faci{ity Total <br /> Exempt ❑Yes ❑ No How Determinad Totai Amount G� <br /> � RESOURCE FEE ERU <br /> 70TA�AMdUPfT � <br /> Prepared By � u Checked By <br /> NO CERTIF(GATE UF OCCUPANCY WiLL BE 1SSUED OR F1NAI.INSPECI'ION <br /> PERFORMED UNTIL THE T47AL AMOUN7S LlSTED HAVE <br /> BEEN PAID AND � <br /> -_ RECEIPTED FOR BY A CENTRAL PERMITfING OFFICE.OF PASCO COUNTY � <br /> Acknowiedgement betow doea not Imp1y accaptance of concucrenoe,but simpiy receipt of�a copy oE this torm,p4aoing <br /> the bufiding permit owner on notice of ihls assessment and tha conditions af paymenk for same. <br /> QATE RECEIVED BY <br /> RECEiPT NO. pATE BY <br />