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w <br /> t I?ASCO COUNTY, FLORIDA <br /> _ - Permit No. <br /> Date Permitted M- <br /> 'Builder Name/Owner Name <br /> County Parcel No. 6"0 t?D O SubDly: <br /> Address/Location �2�1 <br /> Classiflcation/Type of Usq cs a1 <br /> TRANSPORTATION IMPACT.FEE Rate: Sq.Ft Unit. 21&56 <br /> Exempt ❑Yes Q No H w Determined <br /> Impact Fee Amount ," Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> 'Account (666) Single-Family Detached House Amount s )q- <br /> (OR) MobllwHome <br /> (O58) Other Residential <br /> 123) Collection Fee <br /> Exempt [�Yes.:Q'No How Determined <br /> PARKS'AND RECREATIONfEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone ,�� TOTAL AMOUNT s"• (yl.`. <br /> Exempt ❑Yes []1Vo How Determined <br /> LIBRARx FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt C]Yes Q No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked'By <br /> NO CE ITIFICATS'OF.00CUPANCY VALL13E ISSU.ED OR.FINAL:INSPECTION <br /> PERF0WED EIkit THE TOTAL:lkmouk'f' -LISTED HAVE <br /> • BEEN;RAID AND <br /> RECEIPTED FOR,BY A CENTRAL.PERMLTTINO OFFICE-OF PASCO COUNTY <br /> Actcifcwledgement belowdM Mtpaply acceptance ofls'as co�urrence,but simply recelp!ofa copyr.of this form;pleclstg - <br /> ttte buU%iNp perbsit awner:en rtattce of thseasiisent end itiq card#ions of payrn�ti for write. • <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY- <br />