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PASCd COUNTY,FLORIDA <br /> .F'brgdt No. <br /> Date Petmlited' <br /> t <br /> Builder Nams/Owner Name � ' Control#'. <br /> +i County ParSai No. _z � �jLJ SubDiv: <br /> i AddreaslLocadon 011 <br /> c7 �1 <br /> Classiflcationrfype of Ueq <br /> TRANSPORTATION IMPACT FEE • Rate- Sq.Fi Unit Z <br /> Exempt ❑.Yes ❑No Now Determined <br /> Impact Fee Amount ) 2- Zone No. TAZ: i <br /> i SCHOOL_ITF <br /> ' Account (088) Single•Fm*Detechad House Amount $ p",_F�/•`' ; <br /> (067) Mobile Home <br /> (065) Other Residential <br /> ,S1,,23) Collection Fee . <br /> Exempt LJ Yea ❑No How Determined <br /> PARKS AND RECREATtON FEE i <br /> Land Account_ _ Land Credit Lend Total <br /> s Recreation Account Recreation Credit :RecreationTotei <br /> Zone TOTALAMOUNT s 74�c.5b. <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY.FEE <br /> Land Account Land Credit Land Total <br /> Facility.Accciunt Facility Credit Facility Total <br /> Exempt ❑Yes ❑No Haw Determined Total Amour;= i <br /> RESOURCUSE , MU <br /> TOTALAMOUNT <br /> Prepared* Chacked Sy .. <br /> NO CERT(FICATE.OF.CCCUPANCY:WiLL IOBIk$UF O&FINl1L INOVECTION <br /> PERFDRdAED UNTlLTHE?CTAI:ptidOgtll'S1181'Ep <br /> RECEIPTED FOR BY A CENTW,i;RAAflTiN(i OFFtCE•OP PAt3c0 COUNTY <br /> Aduwwbdyoa�ontt�ataopenW,4r�pty,aaeptangpotwncurtgiCe,-butnh�p{yncNptottrwppotUdafam,pleotny <br /> thoadld6�a pamlCowiuron nodes otlhtr®tteunntant iiiiditittBatd(itontbf peylneMioriame. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> i. <br />