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a� <br /> •; FA5CO COUNTY, FLORIDA <br /> � <br /> w <br /> Permit No. Mk <br /> D to Permitted <br /> 'Builder Name/Owner Name( v fol#' <br /> County Parcel No. 0 1`242-1 ,4z6 DabDiv: LAk�, <br /> Address/Location Z en <br /> Classiflcationrrype of UsQ 611 n . <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑lies No How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE. ` <br /> Aunt (058) $Ingle-Family Detached House Amount $ 6 <br /> (067) Mobile Home <br /> ! (068) . Other Residential <br /> 123) Collection Fee <br /> Exempt [�yes..0 No How Determined <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreatlon Credit Recreatio/nTotall <br /> Zone _�� TOTAL AMOUNT $ <br /> Exempt ❑Yes [].No How Determined- <br /> -LIB.RAR.FEE <br /> Land Account Land Credit Land Total <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.CF QC.CUPANCY,WILL.BE ISSUE1>OR-FINAL,INSPECTION <br /> PERFORMED UNTIL THE'r0 ALAMOt;ft.LISTEDHAVE <br /> BEGN.RAM AND . <br /> RECEIPTED FOR BY A CENTRAL`PERMIThit(WF?FICEOF PASCO COUNTY <br /> Acknowledgement below.does not Imply acoeptenca of concurrence,but ftpty►lroceipt ota.coo of this form,placing <br /> dw WNIng 0htdawrWalk notice of#h1s"sessmant and thq conditions of payment for sere. <br /> DATE RECEIVED'BY <br /> RECEIPT NO. DATE BY <br />