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f � <br /> rPA�C� COUNTY, FLORIDA <br /> �. <br /> K <br /> Permit No. ? <br /> Date Permltted '7--LA -1-a?� <br /> ~Buiider Name/Owner Name ctJ �/llL� T71Y7 Control#" <br /> County Parcel No. SubDiv: 151 <br /> Address/Location c� �Z� S t <br /> Classification/Type of Us@ c If <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2�Z <br /> Exempt ❑Yes [] No How Determined <br /> Impact Fee Amount $.-3i 6 _X• zone No. TAZ: <br /> r <br /> { SCHOOL IMPACT FEE / <br /> 1 Account (056) Single-Family Detached House Amount $ 4 <br /> (057) Mobile Home <br /> (068) Other Residential <br /> 123) Collection as <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 $ (09' <br /> Exempt ❑Yes E]No How Determined.' <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt Q Yes ❑ No How Determined Total Amount_____ <br /> RESOURCE FEE ERU- <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISPED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply receipt of•a copy of this form,placing <br /> the building permit owner.on notice of this assessment and the conditions of payment for_Same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />