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f ' <br /> ' PASC COUNTY, FLORIDA <br /> ' Petgtit No. �-Z� <br /> y Date PeonittsO <br /> ~'_ <br /> Bulkier Name/Owner Name A� Control fY' • <br /> County Parcel No. .2 1101 /�{rJ» Z�o�*SuttDtw 6�r���t <br /> Address/Location �3z1 Z- rY) L <br /> CtassiflcatlonRype of Usq <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: I <br /> Exempt [:]Yes ❑No !I How Determined <br /> F Amount 3 �t 3 f Zane No. TAZ: <br /> Impact Fee $. L. i <br /> SCHOOL IMPACT FEE <br /> Account (Ot3O) Single-F Ily Detached House Amount $ Z <br /> (OST) Mobile H a <br /> (055) Other tdentist <br /> 123) Collectio Fee A <br /> l Exempt Yes ❑No How Determined <br /> PARKS'AND RECREATION EE. <br /> Land Account Land Credit Land Total 1 <br /> Recreation Account Recreation Credit •Recreatlon Total <br /> TOTAL AMOUNT 7 cS <br /> Zone <br /> I <br /> Exempt ❑Yes ❑Na How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facillty.Accdunt Facility Credit Facility Total l <br /> Exempt ❑Yes ❑N� Now Determined Total Amountz�' i <br /> RESOURCEFEE I , ERU <br /> TOTAL:AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE F OCCUPANCY Wi1(.BE ISSUED OR FINAL INSPECTION <br /> PERFO ED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FO BY A CENTRAL PERMITIING OFFICROF PASCO COUNTY <br /> Acknowladpamantb&w not Imply acceplanee of eoncurranoa.but�+plyreCalptots copy of We form,placing <br /> iDeDulidfnppormit wnarannotkaotWsasaesunentsrrfitlea>ndNAr�sfr otpaymarlt far aama <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> ' N <br />