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' PAS CO COUNTY, FLOMOA <br /> Pgrq*No. <br /> ` Date PoUnl111eJ0/ <br /> EBuilder Name/Owner Name /G� /Control#' <br /> County Petrel No. - - - ���� 60'(�spubDiv: <br /> Address/Location W e �` <br /> ClassMcauonl ype of Usq i <br /> TRANSPORTATION IMPA • FEE " Rate: Sq.Ft Unit: 2L <br /> FExempt ❑you ❑No How Determined <br /> Impact Foe Amount 3 1 Zone No. TAZ. <br /> E <br /> SCHOOL IMPACT FEE r <br /> Account (068) Single-F Ily Detached House Amount 7'MS.7-6 <br /> (067) Mobile ome <br /> %58) Other R sIdengal <br /> 23) CoileclC n Fee <br /> Exempt d Yes ❑No How Determined <br /> II i <br /> PARKS AND RECREATIOI FEE i <br /> Land Account Land Credit Lend Total <br /> Recreation Account Recreation Credit "Recreatlon Total �y <br /> Zone TOTAL AMOUNT <br /> • I <br /> Exempt ❑Yea ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Faclllty.Aocount Facility Credit FacWty Total <br /> Exempt ❑Yes ❑No How Determined Total Amount 'b-, _ I <br /> RESOURCEFEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t Chocked By <br /> NO CERTIFICATE F.000UPANCY WILL BE ISSUED OR FINALINSBECTION <br /> PERFO ED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR Y A CENTRAL PERMITTING OFFICSOF.PASCO COUNTY <br /> A4WWW dpomant btlow OU 11OL WO aweptaneo of wnoumenm but SMVIY rMlpt ofa'wpy of this romp,placing <br /> Me WNW parmh o inif on notice of Oft aeteatmant and the wndluona of payment for tame. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> %r <br />