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; t <br /> ` � PASCt3 COI�[�T'Y, �LtJRIDA <br /> . . .' ' ' � Permtt Na. � t �j 3 <br /> , ' Data Permltted ��;�-t'� <br /> Buiider Name/0wner Name ��'-nytLt-,- ���5 L-�''C Control# <br /> County Parcel No. 2�ZG�-2f-(�o9f�-tK�}-�O�t b SubDiv: c��P.�fL�L�r <br /> Address/Location �Jt�J�, !"�O+�tG���t�t9t� �1�2 <br /> ClassiflcatlonlType of Use , (� <br /> TRANSPORTATIOH IMPACT FE Rate: Sq.Ft Unit: 2. Z Z <br /> Exempt �Yes ❑ No How Determined <br /> � impact Fee Amount $. �7 �a 32� Zone No. TAZ: <br /> SGHOt?L IMPAGT FEE <br /> Account (056) Singte-�amNy Detached House Amount $ �-i�,°i"?�i� � <br /> (057} Mobile Home <br /> (058) Other Resldentia{ <br /> 123) Coitectton Fse <br /> Exsmpt []Yes [�No How petermtned <br /> PARKS AND RECREATtt}N FEE <br /> Land Account Land Credit �and Totat <br /> Recreation Accaunt EZecreation Credit Recreation Tatal <br /> Zane Tt3TAL AMOUNT $ �t2-`�.��, <br /> Exempt ❑Yes ❑ No Haw Determ[ned <br /> L[BRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facitity Credit Faciftty Tatai <br /> Exempt []Yes ❑ tVo How Qetermined 7otat Amount���7"��, <br /> RESOiIRCE FEE ERt! <br /> TOTAL AMOIlNT � <br /> Prepared By Checked By <br /> NO CERTIFlCATE OF OCCUPANCY WtLL BE{SStlEd OR FINAL INSPEGTION <br /> PERFC3RMED UNTIL THE TOTAL AMOUNTS LISTEI�HAVE <br /> BEEN PAtD AND <br /> RECEiPTED F4R BY A CEN7RAL PEi2MiTPiNG OFEICE OF PASCO COUN'TY <br /> Acknowiedgement betow does not lmpty acceptance of cancurrenca,but slmpfy recefpt of a copy of thls form,p{acing <br /> the bullding permft owner on notice of thls assessment and thq cond{iians of payment for sama. <br /> DATE RECEIVED RY ' <br /> RECEIP7 NO. DATE BY � <br /> � <br /> ,._.___...___._�r-,�.:�::_.:�:�.�._.�._�z <5_�.:�=m_-�_=.-,M1-,.W �._a,._ <br />