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� � : PASCO C�IJNl'Y, �LORIDA <br /> , � Permit No. `�l � <br /> �� `-����(,�C' Date Permftted /—( �( <br /> L <br /> Builder NamelOwner Name � Control# <br /> , Counry Parcel No. �5—��2{—�(��j_�(o0—(SbZa SubDiv: �� (f 2��Q <br /> � �2?f Z (�t� (nR., cS7— <br /> t� AddresslLocation <br /> ClassiflcatlonlType of Use c5l '� `� , <br /> ,�.• TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: zl �� <br /> t;: <br /> r;, Exempt �Yes � No Ho�v Determined <br /> `��; � Impact Fee Amount $. ��p c3Z Zone No. <br /> ;:r TAZ: <br /> �=, <br /> �'�; SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ �g 7�,� 2..�j <br /> .. (057) Mobile Home <br /> (058) Other Resldential <br /> 123) Collection Fee <br /> Exempt [�Yes a No How Determined <br /> PA9tKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit �Recreation Total <br /> Zone TOTAL AMOUNT $ ��09� ��� <br /> � Exempt �Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Faciliry Credit Facility Total <br /> - Exempt � Yes � No How Determined Total Amou <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT � <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPAfdCY WILL BE ISSUED OR FINAL INSPECTION <br /> •� PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> _�, BEEN PAID AND <br /> ��: RECEIPTED FOR BY A CENTRAL PERMI'RING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence,but simply recelpt of a copjr of this form,placing <br /> °- lhe bullding permit owner on noUce of this assessment and thQ conditlons of payment for same. <br /> 9 <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE gY <br />