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i <br /> : PASCO COUNTY, FLORIDA <br /> Permit No. <br /> II Date Permitted <br /> Builder Name/Owner Name �(A Control#' <br /> County Parcel No. D�.26 2_'f n J zo D 000a)q q� subDiv: /$ <br /> Address/Location (o <k Ana' rC{ <br /> Classiflcationlrype of Usq SI,YxI I0, G, <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes [].No How Determined <br /> Impact Fee Amount $. Zone No. TAZ: <br /> SCHOOL IMPACT FEE `[ <br /> Account (056) Single-Family Detached House Amount $ 91 7[I, 2A <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt d Yes- .❑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 <br /> G <br /> i Exempt ❑Yes © No How Determined <br /> i <br /> • , LIBRARY FEE <br /> ` Land A(%eunf Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes [] No How Determined Total Arnow <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 LISTED 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 paymemf for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />