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. <br /> . ; � � � P�4SC0 COUNTY, FLORID�q <br /> , Permit No, q��� <br /> Date Permitted –� <br /> Builder Name/Owner Name U�.yl� �5�.�, <br /> � . �Control# <br /> County Parcel No, CJZ��'a—2(—U300_��p���ubDiv: r� <br /> Address/Location (� ��j[� ���v„/ n.� _ !'� <br /> �l l�!Y�F <br /> Classf�catloNType of Use p�� <br /> �►�` ���� <br /> TRANSPORTATION IMPACT FEE <br /> Rate: Sq.Ft Unit: j���_ <br /> Exempt � Yes � No How Determined <br /> � Impact Fee Amount $. ` � <br /> Zone No. _�_ T�: <br /> SCHOOL IMPACT FEE �— <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Othe[Resfdential <br /> �123) Collectlon Fee <br /> Exempt Yes � No How Determ(ned <br /> PARKS AND RECREATION FEE <br /> Land Account <br /> Land Credit Land Total <br /> Recreation Account ` <br /> —�_ Recreation Credit <br /> �_ Recreation Total �_ <br /> Zone <br /> -- TOTAL AMOUNT $ �f�� 5'� <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account <br /> Land Credit <br /> Land Total <br /> Facility Account <br /> �_ Facility Credit • <br /> Facility Total <br /> Exempt � Yes � No How Determined <br /> .—�_ Total Amo�t�� <br /> RESOURCE FEE <br /> TOTAL AMOUNT ERU <br /> Prepared By <br /> Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINqL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUN7S LISTED HAVE <br /> RECEIPTED FOR BY A CENT ALE ERM'11'T NG OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply recelpt of a copy of this form,p�acing <br /> the buflding pertnit owner on notice of this assessment and th�conditfons of payment for same. <br /> DATE <br /> RECEIVED By <br /> RECEIPT NO. �_ pATE <br /> �_ BY <br /> n:��..,..m,�,.�.� -- <br />