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PASCO COUNTY, FLORIDA <br /> Arot No. ?,--?7b 3 <br /> •�. •' ti` Date PeoNtted <br /> BuildedNemelOwner Name LeA h Control q' <br /> County Pagel No.S Z4-2— 61,(0-0a)D-JD7DSubDiv: a(� en 1, f <br /> AddresslLocetion ` , r <br /> ClesslflcatlonlType of UsQ <br /> �. TRANSPORTATION IMPACT FEE Rate: sq.Ft unit: Z-3 <br /> i. Exempt ❑Yes ❑No How Determined <br /> i <br /> Impact Fee Amount $. f 3�' Zone No. TAZ: <br /> f' SCHOOL-IMPACT FEE �1 <br /> Account (056) SlrgiWamlly Detached House Amount S <br /> (057) Mobile Home <br /> (055) Other 123) Collection Residential Fee <br /> I. Exempt b Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> �n reatlon Account Recreation Credit <br /> TOTAL AMOUNT a a a0o %talc'S <br /> I <br /> • I <br /> Exempt ❑Yes ❑No Now Determined <br /> LIBRARY FEE <br /> Lend Account Lend Credit Lend Total i <br /> Factlity.Acoount Facility Credit FacliilyTotal <br /> Exempt ❑Yes ❑No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL IIIE ISSUED ORFINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL'AMOUNTS LISTED HAVE <br /> .BEEN'PAIDAND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICROF PASCO COUNTY <br /> Aolm-ledsomant befow 4oee not bnpty acceptance of wncurrenco,but Wm*receipt ofs copy of this form,placing <br /> the bWlding psnNI owner en notloe of thle asa®esment and rho canton of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />