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PASCO COUNTY, FLORIDA <br /> ! Permit No. Q z _ <br /> pate Permitted 40-7d-2o2�a <br /> Builder Name/Owner Named) k Pvr4n-t Control W " <br /> County Parcel No.--7 1 B35 2-52 7-t 151,?`010-Pi O o t 2b SubDiv: �,QktIT/0 <br /> Address/Location L 1 r-o d i'n k- Dg- <br /> Classification/Type of UsQ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: ,, 2�38 <br /> Exempt Yes Q No // How Determined <br /> r• <br /> Impact Fee Amount $.3l (a.32-- Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> s Account (056) Single-Family Detached House Amount $ - -�-f2 <br /> (057) Mobile Home <br /> i (058) Other Residential <br /> 123) Collection Fee <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 $ <br /> •Exempt ❑ Yes [] No How Determined <br /> LIBRARY FEE \ <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Atnount�._ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By 1 6 9 ,_ 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 PERM17TIN©OFFICE OF PASCO COUNTY <br /> Ackrfowledgement below does not Imply acceptance of concurrence,but simply receipt of a copy of this form,placing <br /> Me building permit owner.on notice of ffsGs assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />