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r`-` <br /> t F/ Cf).GCUITY, L ►RID►�►� <br /> Permit No. � <br /> Date Permitted l <br /> Builder Name/Owner Name V' +fr� Control#' <br /> County Parcel No. :3'2 2�2a ? p i 50b b(�o subDiv: ? 1:� <br /> Address/Location 7Z 15 <br /> ClassificaflonlType of Use <br /> TRANSPORTATION'IMPACT FEE . Rate: Sq.Ft Unit: <br /> Exempt []lies C],No t_How Determined <br /> Impact Fee Amount. $: . �Z� Zone No. TAZ; <br /> SCHOOL'IMPACT=FEE. / <br /> Account (056j Sli gle=Family Detached"House Amount $0 (., <br /> • (057) Mob1le Home <br /> { (408}, OftiAesid®ntlal <br /> 1.23)• .Colleftlori Fee <br /> Exempt [�Yes. Q,No How determined <br /> PARKS AND'RECREATIOWFEE- <br /> Land AocbUht 'Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone _ TOTAL AMPUNT 7&F. <br /> 'Exempt Yes No How Determined' <br /> LIBRARY FEE <br /> ` Land Account Land-Credlt Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes Q No How Determined Total Amount _ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By i• �'� Checked By <br /> NO E'RTIFICATE;,OF OCCUPANCY;WILL.BE ISSUED OR FINAL INSPECTION <br /> PERFBRMED:UNTIL"I'iMIti''PX AM614NTS LISTED HAVE <br /> BWPAID°AND <br /> RECEIPT D FOR BY A CENTRAL.PERMnTIN®OFFICE-OF PASCO COUNTY <br /> AckiioNdedgement belOwdoes not Imply aoce,w"of concurrence+but simply aftlpt of•a oopY of.this form,-placing <br /> e bulidtng perrntt bwrssr on notice of thle'assessment and the condltlons of payment for seine. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />