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.� I <br /> i �ASCO COURITY, �FLORIDA <br /> � Permit No. B� <br /> ' Date Permftte /��_�B <br /> Builder Name/Owner Name ��/C ���j� G� Control# <br /> ,� County Parcel No. (�_�'_Z��0&jT/�!�(o�z ,.0�2oSubDiv: s' � <br /> Y AddresslLocation �Q l� 3 c S <br /> '` ClassiflcatioNType of Use �'� �� f <br /> �,`� TRANSPORTA�'ION IMPACT FEE Rate: Sq.Ft Unit: 2� �3$ <br /> i�: <br /> ` Exempt � Yes � No How Determined <br /> `� � Im act Fee Amount $, 3(Q��� <br /> P Zone No. Tp,Z: <br /> �`" � SCHOOL IMPACT FEE <br /> ,.. <br /> Account (056) Single-Family Detached House Amount $ ��j 7�� 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 Land Total � <br /> Recreation Account Recreation Credlt -Recreation Total <br /> Zona TOTAL AMOUNT $ 2�� �� <br /> Exempt � Yes � No How Determined <br /> - LIBRARY FEE <br /> _ Land Accounf Land Credit Land Tptal <br /> � Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount �/_ <br /> RESOURCE FEE ERU ' <br /> TOTALAMOUNT <br /> Prepared By Checked By i <br /> - NO CERTIFICAYE OF OCCUPANCY WILL BE ISSUED OR FINAL INSI'ECTION <br /> .. PERFORMED U(dTIL THE TOTAL AMOUN7S LISTED HAVE <br /> �EEN PAID AND <br /> r RECEIPTED FOR BY,4 CENTRAL PERMITTING OFFICE�OF PASCO COUNTY <br /> r Acknowledgement below doea not imply acceptance of concurrenca,but simpty recelpt of a copy of this form,placing <br /> `- the bullding pertnit owner on notice of thls assessment and thQ condiUons of payment for same. <br /> DATE RECEIVED BY <br /> � RECEIPT NO. DATE gy <br />