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. t <br /> . PASCC)_.COUNTY, FLORIDA - <br /> Permit No. J `3 <br /> Date Permltted <br /> +Builder Name/Owner Name Li Control#• " <br /> County Parcel No. 0 4 Z1 6110 606on Q 3 m SubDiv: d*s afi �o <br /> Address/Location s Y' <br /> Classification/Type of Use m/l,T _ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount = Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Oollectionfee <br /> i Exempt [ Yes_ ❑No How Determined <br /> PARKS AND:RECREATION'FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT '. <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount C- <br /> RESOURCE FEE ERLI <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE'.QF OCCUPANCYVILL BE.ISSUED-ORfINAL INSPECTION <br /> PERFORMED'UNTIL THS-VOTAL AMOUNi'S°LISTED HAVE <br /> B(.EI!k PAlD;AND. <br /> RECEIPTED-FOR BY A CENTRI%t PERMITTING OFFICEOF PASCO COUNTY <br /> Acknowiedgementbelow does.rtotimplyacceptance of cancurrance,but simply,receipt of a.copy of this form;placing <br /> the bullding peftit owner on notice of tote assessment and the,oondltlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />