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PASCO COUNTY, FLORI®A <br /> .. . P�f4tlt No. . Z277�6 <br /> Date Peanittsd <br /> Bulkier NamalOwner Name n n�/—6 ty'"' Control W <br /> � County Patcel No. 2 4— <br /> Address/Locauon �31 Za Gdk1J '�a <br /> h <br /> ClassiflcatloM -71ype of Usq nGt N _ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑No How Determined <br /> f <br /> Impact Fee Amount 3 3 •(� Zona No. TAM <br /> SCHOOL IMPACT FEE ''@g <br /> Account (088) Sln®Ie-Family Detached House Amount $ ��W ; <br /> (087) Mobile Home <br /> (088) Other Residential <br /> 23) Collection Fee <br /> + Exempt b Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> I <br /> Recreation Account Recreation Credit •Recreation Tolel <br /> Zone TOTAL AMOUNT <br /> • I <br /> Exempt 0 Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Faclllty.Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑No How Determined Total AmouB�e- I <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By ask== Chocked 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 OFFICEOF PASCO COUNTY <br /> Acknowledgement below deal not Imply acceplenea of concurrence ply,but sim r"pt oft copy or thta form,placing <br /> the building peWtowner on'notlke of Nla assesamen(and tAa condl0M3 of payment for tame. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />