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i <br /> �. PASCO COUNTY, FLORIDA <br /> Permit No. 425�0 <br /> cj, Date Permitted —1 <br /> -Builder Name/Owner Name {t) Q tiJr � Control# <br /> County Parcel No, [} 2(0 2 t.0 OBP^b�(flpD-b z t b .SubDiv: �, ( r a <br /> Address/Location Oy+ �t(64s <br /> ( <br /> t <br /> Classitication(rype of Use 6 e t <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Zt 3�rZ i <br /> Exempt []Yes ❑ No How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> '. Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> ?' (056) Other Residential <br /> 123) Collection Fee <br /> Exempt n Yes ❑ No How Determined <br /> ' PARKS AND RECREATION FEE { <br /> Land Account Land Credit Land Total <br /> i Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ �torJ <br /> i <br /> Exempt ❑ Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ Na How Determined Total Amaun <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> v <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> r• Acknowledgement below does not imply acceptance of concurrence,but simply receipt of-a copy of this form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY j <br /> 4 , <br />