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4v <br /> PASCO COUNTYLORIDA <br /> Permit No. <br /> Date Permitted <br /> 'Builder Name/owner Name I t"Control#• " <br /> 'r • r rIf/� r <br /> County Parcel No. 67 2W*1 b660QD7C(p'.. SubDiv: yI CL'I`cA9►u$ <br /> Address/Location t: <br /> Lf Lunn IA" <br /> ClassiticatioNType of Use) 4M["IV <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt []1(es Q No How Determined <br /> Impact Fee Amount 4c�- Zone No. TAM <br /> SCHOOL IMPACT FEE C��/ <br /> E Account (058) Slrigle=Family Detached House Amount $ �, r l ( . <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 4 123) Collection Fee <br /> Exempt a"Yes. E]No How Determined <br /> PARKS'AND.RECREATIOWFEE. <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL.AMOUNT <br /> Exempt Yes O No How DeteftlneA <br /> LIBRAI FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt Yes No How Determined Total`Amou . <br /> RESOURCE'FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By _ Checked By <br /> NO CERTIFICATE OF;O,CCUPANCY.WILL BE;ISSUEQ OR:FINAL INSPECTION <br /> PERFOR D UNTIL THE TOTAL"AlOOt1NTS"L ISTED HAVE <br /> BEEN PAID AND: <br /> RECEIPTED FOR BY A CENTRAL;PERMITTINO`OFFICE•OF PASCO,COUNTY <br /> Ackitowledgement;below.doesnot Unply.sccaptance of cancunenoe,but s"ply receipt of a copy<of thla;form,placing <br /> tl�e penult owner"on'notice of this esseseinent and thq conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />