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k <br /> PASCO COUNTY, FLORID <br /> r <br /> •„ Permit No. <br /> / j Date Permitted 2 :� <br /> Builder-Name/Owner Name a Y�i e Control# <br /> County Parcel No. Qq 2,0 2-1612 u` G � 7� SubDiv: <br /> Address/Location S <br /> i� <br /> ClassiticationRype of Use 6- <br /> j` TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 4 SW <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 $ �� lf• <br /> (067) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> l Exempt [�Yes ❑No How Determined <br /> i <br /> i. PARKS AND,RECREATION FEE, <br /> t Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> i <br /> i <br /> „. Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑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 LISTED HAVE <br /> BEEN:PAID AND <br /> RECEIPTED FOR.BY A CENTRAL PERMITTINt9 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 />