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Ovate vermitted /,7.—„y_AVX0 <br /> 'BLllder Name/Owner Name ���� ` Control#' <br /> County Parcel No. L151,20 000d i) SubDly: s. <br /> AddrssWl ocatlon 1.39 <br /> ClaesiflcationlType of U_"r <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: 1l <br /> Exempt Q Yes 0 No Hoer Determined <br /> Impact Fee Amount ;_ Zone No. TAM <br /> !BCHGOL`IMPACT FEE' . <br /> Akxx}unt (056) SirigI*0amily Detached House Amount $ � <br /> (0$7) .tl+olgle.Nome <br /> t (0 0) Other Ftesldentiat <br /> 123) 'Collection fee <br /> Exempt [ Yes..ONO How Determined <br /> PARK&ANWRECREAT ON EEE- <br /> 1,ar►d'Accaunt Land Credit Land Total <br /> f Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ l9' <br /> Exempt ❑yes <br /> �]No How Determined' <br /> .LIBRARY FEE` <br /> Land Account Land Credit Land Total <br /> Facility Account Facilty-Credit Facliity Total <br /> Exempt 0 Yes n No How Determined Total AmountL-../ <br /> RESOURCE.FEE ' � � ERU <br /> TOTAL AMOUNT <br /> Prepared By I&I Checked By <br /> NO CERTIFIC I TO Ot;OCCUPANCY.WILL BE ISSUEQ OR FINAL INSPECTION <br /> PERFORMED UNTIL THETOOTAL AMOUNTS LISTED HAVE <br /> 13EE14 PAID.AND <br /> RECEIFTED FOR 13Y A CENTRAL 015AMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does root lmpiy acceptance of oonourrenca,but o;empty receipt of a copk of this form,placing <br /> the buRtling permit owner on notice of thte assessment aad tho ccnattio of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />