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PASCO COUNTY, FLORIDA <br /> Permit No. t Z <br /> - - Date Permitted 12- <br /> yBullder.Name/Owner Name TI � Control#" ' <br /> County Parcel No. Q Lf 26 2-/Df 2r? 00 _ SubDly: 00 -t�b�, <br /> Address/Location Zq s <br /> Classlfication/Type of Uso- e <br /> TRANSPOitTATION IMPACT FEE Rate: sq.Ft Unit: 2 .t <br /> Exempt ❑Yes (] No Hqw Determined <br /> Impact Fee.Amount $,,e- / Zone No. TI M <br /> SCHOOL <br /> Account (Ost3) Single=Family Detached House Amount $ qq W 2�j <br /> (057)' NttSblte Hofne <br /> ! (050), :Oilier ResfdentlaI <br /> Coliaction Fee <br /> Exempt Yes. Q No How Determined <br /> PARKS',AND RECREATIONFEE- <br /> l.and'Acoourit Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone. _ �. TOTAL AMOUNT $ <br /> Exempt [Q Yes [ No How Deteimined7 . <br /> t:IBRAR -FEE <br /> Uh&Accourlt Land 6radlt Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount = 1 <br /> RESOURMFEE:: ERU <br /> T01AL_AM6UNT <br /> Prepared By Checked By <br /> -NO CERTIFICATEbF:OCCUPANC.Y WILL BN:ISSU 0,011:FINAL INSPECTION <br /> 00061*Eb UNTIR THE:'t'O`PiAir;ANiOCINTS:LISTED HAVE <br /> • BBEN°:P..#dD,AND <br /> RECEIPTED:FOR I5Y A.CENTRAL`PLRMI9TIN0 OFFICE-OF PASCO COUNTY <br /> Aclirtowiedgement.belouv does not Imply acceptance of concurrence,but slmpiy,recelpt of•a copy of_thla form,placing - <br /> the bullding peftk owner on nits of this assessment and tha conditions of payment for same. ' <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />