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PASCO COUNTY, FLORIDA <br /> Permit No, <br /> Date Permitted 5-0-10 <br /> Builder Name/Owner Name C- Control <br /> County Parcel No. 0,5-2_ -V_00 _ot)6d 04W 7 C)SubD!v: 3 <br /> Address/Location 71-m-, <br /> Classification/Type of Use 7_4� ICU <br /> U <br /> TRANSPORTATION IMPACT FEE Rate: Sq-FtUnit: <br /> Exempt nYes 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 /> (058) Other Residential <br /> (123) Collection Fee <br /> Exempt []Yes n 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 F] Yes F1 No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> 174--y— <br /> Exempt n Yes No How Determined Total Amount-/ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> C/ <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 />