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` � � PASCO COUtVTY, fLORIDA <br /> , Permit No. �� <br /> - Date Permitted - �D�( <br /> Builder Name/Owner Name�I`L��jy� �iC. Control#' <br /> Counry Parcel No. [�S-Z6-2l-.nv�-OLYo[b,Op(0 SubDiv: ���Uera c�b <br /> AddresslLocatlon Zp p� � � S( <br /> 0 7 f,l S�01n rr, <br /> !, ClassiflcatloNType of Use �r �e �heimc� <br /> �, <br /> {: • <br /> ��; <br /> �,; TRANSPORTA�ION IMPACT FEE Rate: Sq.Ft Unit: ��Z 33 <br /> i..� <br /> ��, Exempt �Yes � No Ho�r Determtned <br /> r'; <br /> �' � Impact Fee Amount $..3,��z�bU Zone No. Tp,Z; <br /> ,:: <br /> i:-i. <br /> �_' SCHOOL IMPACT FEE <br /> ',. Account (056) Single-Family Detached House Amount $ _ �� 8'Z(o.� <br /> !` (057) Mobile Home <br /> a (058) Other Residential . <br /> ' 123) Collectlon Fee <br /> ' Exempt [� Yes a No How Determ(ned <br /> PARKS AND RECREATION FEE <br /> Land Account Land Cradit Land Total <br /> Recreation Account Recreation Credit �Recreation Total <br /> Zone TOTAL AMOUNT $ �(�9,c'�,(� <br /> Exempt � Yes � No How Determined � <br /> LIBRARY FEE <br /> ' Land Account Land Credit Land Total <br /> ':'�' Facility Account Facility Credit Facility 7otal <br /> i+ � <br /> Exempt �Yes � No How Determined Total Amount <br /> RESOURCE FEE ERU � <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> " NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUfVTS LISTED HAVE <br /> `� BEEN PAID AND <br /> r RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> � Acknowledgement below does not imply acceptance of cancurrence,but simply recelpt of a copy of thls form,placing <br /> � the bullding permit owner on noUce of thls essessment and thQ conditlons of payment for same. <br /> � DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />