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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name Olt fV),— � � Control# <br /> County Parcel No. 6!!�-2�-2_1—jtVP—&1:�Z Z6L )SubDiv: \51' XAWO <br /> Address/Location 65 9W k GU <br /> Classification/Type of Use � <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3- <br /> Exempt ❑ Yes ❑ No / How Determined <br /> Impact Fee Amount $.�i 6 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ 8�5 <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes Q 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 $ 76 St <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 -d By <br /> NO CERTIFICATE OF/ "R FINAL INSPECTION <br /> PERFORV SO HAVE <br /> RECEIPTED W � C 1!0 COUNTY <br /> 0 <br /> Acknowledgement" �' ��^ °2& ra copy of this form,placing <br /> the b' o'y °gO payment for same. <br /> v. <br /> DATE. `cy - iECEIVEDBY <br /> RECEIP"i . ':>�o Q-f7 3Y <br /> 61Q <br /> °C� <br />