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µ` <br /> J}� PAS COUNTY, FLORIDA <br /> t N <br /> Permit No. l <br /> Date Permitted 7--7-3— <br /> Builder Name/Owner Name ke_ Control#. <br /> County Parcel No. Zq�-24-V—0C -OBI QC--Of)�r'� SubDiv: l ( <br /> Address/Location <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: (OS <br /> ❑ No How Determined <br /> Exempt ❑ 'Yes <br /> Impact Fee Amount $. / C7 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount <br /> (067) 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 Amou <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By ulb 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 />