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f [[ <br /> PASCO COUNTY, FLORIDA <br /> Permit No, <br /> -� �// f Date Permitted I�- <br /> �Builder Name/Owner Name U/f� l s NA`0 Control W <br /> County Parcel No. 34 2-5,Z l"6,0 9o. d l l "SubDiv: 67fz . <br /> Address/Location 0 /--,'7 <br /> ll s/ . <br /> ,Y Cfassiflcationlfype of Use ��+ !'e <br /> `$ TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: - -- <br /> Exempt ❑Yes ❑ No Hod►Determined <br /> Impact Fee Amount ".$. ` � Zone No. TAM: <br /> SCHOOL IMPACT FEE <br /> Account" (056) :SlrigliFamily Detached House Amount $" <br /> (057) Mobile-Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt d Yes []No How Determined <br /> I - <br /> PARKS,_AW RECREATION,FEE, <br /> LandAccount Land Credit Land Total <br /> Recreation Account Recreation"Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 73>`7.v� <br /> Exempt ❑Yes [) No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Faci ity Total <br /> Exempt ❑Yes [] No How Determined Total Amount <br /> RES.OURCE'FEE- ERU <br /> TOTALAMOUNT <br /> Prepared By ' Checked By <br /> NO CERTIFICATE�p1=OCCUPANCY WII L,BE:IS3.UEpOR=FIIdAL:INSP"ECTION <br /> PER'N=©RMED:Cli�tTlE>Ttl��'A7'AI.1tMO1JN1'S.LiBTED:Hi4VE <br /> B.OMPAIMANCl: <br /> RECEIPTED:FOR.BY.A CENTRi4�I:-$ERMITTtN0 OPFiCE.OF PASCO COUNTY <br /> Acknowfedgement,balow.doss not imply acceptapce;of.concurrence,but stmpiy'feoelpt of•a copy of"ihie.form;Placlno <br /> ft buliding pemiffown®r•'o4'notice of tliis"asseseiment and tha-condlticns of payment forsama.' <br /> DATE RECEIVED"BY <br /> RECEIPT NO. DATE BY <br />