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i 4 <br /> IPASCO COUNTY, FLORIDA <br /> Permit No. 1WE� <br /> �// Date Permitted <br /> Builder Name/Owner Name &tAr� WAS kJK,,� Control# <br /> County Parcel No. I)J-Zb 2(—OCR&Q—D06 op- 637a SubDiv: .51 111"A <br /> Address/Location tti i�5 W 7— <br /> lie <br /> Classification/Type of Use slnq 1 <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2j372, <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $.3c 3Q.Dz) Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <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 Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <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 [] 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 AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE,OF PASCO COUNTY <br /> 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 <br />