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Ovate Permitted t0-20,' <br /> "Budder Nsme/Owner-Name Control#' <br /> County Parcel No. Zr(I 2. Z/ 611:o0,000 0E0 SubDiv: �- <br /> Address/Location C"/ <br /> Classificatlon/Type of Use Si ' <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: c3 2- <br /> Exempt ❑Yes [Q No How Determined <br /> impact Fee Amourit $. 3 L5 Zone No. TAZ: <br /> $CHOOI )MPACT;FEE <br /> Account (056). 8I000e-Farnliy petached House Amount $ <br /> (057) Moplte-dome <br /> (958) Other"Residential <br /> 123), Coilecti6n Fee <br /> Exempt [�Yes. Q No How Determined <br /> PARKS,ANDNRECREATION'FEE` <br /> Land Ac66unt land Credit land Total <br /> Recreation Account Recreation Credit . Recreation Total <br /> Zone TOTAL AMOUNT <br /> Exempt ❑Yes ❑No How Determined` <br /> LIBRAR�(;FEE <br /> I:and AcCoF Land-Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes 0 No How Determined Total Amount CT <br /> -RES.OURCE=FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By 141ra, Checked By <br /> -NO CERTIFICATE OF OCCUPANCY WILL:BEdSSUED-OR-FINAL.INSPECTION <br /> PERFOiFtMER ClNTI'Li E.Tfi1'f 4t..1tMOtf!NTS'ItSTED.HAVE <br /> • BEAN i?AiD AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE�OF PASCO COUNTY <br /> Acl(iId iedgement below does not imply acceptance of concurrence,but pimp l�yy repipt ofa copy of INS form,placing <br /> the buiidit permit owner+'on notice of this asseasment and tha conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />