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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Builder Name/Owner Name <br /> <br />Permit No. /3 'f Lf <br />Date Permitted (p - ;Zs - 0 ~ <br /> <br />G~cO ~~ Control # <br /> <br />County Parcel No. D3 --2& - L (- D 2-00 - ooF 0 <br />Address/Location lc~(0'-L-J~JcO LN. <br />Classification/Type of Use ~~J.J S 1 '^tz <br /> <br />SubDiv: <br /> <br />s~~ !J~ V:'Iky- <br /> <br />TRANSPORTATION IMPACT FEE Rate: <br />Exempt ~Yes D No How Determined <br /> <br />9 <br /> <br />Sq Ft Unit: <br /> <br />Impact Fee Amount $ <br /> <br />Zone No. <br /> <br />TAl: <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House Amount $ <br />(057) Mobile Home <br />(058) Other Residential (,)1\ _ -0'-- 0 <br />J.:123) Collection Fee fD< \ ~ ~ ~ n .D !' ,?--'iSS t;; <br />Exempt U Yes 0 No How Determined)~ \ <br /> <br />/1 0 CZL( <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br /> <br />Recreation Account <br /> <br />~ ion Credit Recreation Total <br />~ <br />./---- TOTAL AMOUNT $ <br /> <br />Zone <br /> <br />-- <br />"....' <br />~~ <br /> <br />Exempt.,/[Jves D No <br />./ <br /> <br />How Determined <br /> <br />Facility Account <br /> <br /> <br />Land Credit <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />Facility Total <br /> <br />Exempt /p_ <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />...- <br />RE'SOURCE FEE <br />TOTAL AMOUNT <br /> <br />/CJ. 95 <br /> <br />ERU <br /> <br />Prepared By ~Or ~ ~heCked By <br /> <br />NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br />BEEN PAID AND <br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing <br />the building permit owner on notice of this assessment and the conditions of payment for same. <br /> <br />DATE RECEIVED BY <br />RECEIPT NO. Seg/tJ V DATE /~~f~~ BY <br />