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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />.#- / 3-?5 ,~ <br />Permit No.... tAu.. <br />Date permit~a:tl:-.~c: 3 0. t). '. <br /> <br />Builder Name/Owner Name {J/Jv'li) U..I :f/YI/J5[?A,j Control # "--.-_._.______.__.,____.... 5!1..ee:e- <br /> <br />County Pai cel No, (!) Z . 2(-) '-? ( - 0 Z6Z) - (it) />1-()-- OO(o~bDiv: <br /> <br />Address/Location ~ ~~I ,? []r-lIL:,,-r<~.p {"F /{)/J.l( -2- III t' Is I j-;:'L ''3~:j<;J "!:. <br />.k -i: I ' <br /> <br />Classification/Type of Use __ <br /> <br />4,1(J~ \()'Y <br />\ ~. )1'1 <br /> <br />TRANSPORTATION IMPACT FEE Rate: <br /> <br />Sq Ft Unit: <br /> <br />Impact Fee Amount $ <br /> <br />Zone No. <br /> <br />TAZ: <br /> <br /> <br />Exempt [J Yes 0 No <br /> <br />How Determined <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />~23) Collection Fee <br />Exempt U Yes 0 No How Determined <br /> <br />Amount $ <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br />Land Total <br /> <br />Recreation Account <br /> <br />Recreation Credit Recreation Total <br /> <br />Zone <br /> <br />TOTAL AMOUNT $ <br /> <br />Exempt [J Yes 0 No <br /> <br />How Determined <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />Land Credit <br /> <br />Land Total <br /> <br />Facility Account <br /> <br />Facility Credit <br /> <br />Facility Total <br /> <br />Exempt 0 Yes 0 No <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />\. <br /> <br />..... <br />RESOURCE FEE ) <br />TOTAL AMOUNT' <br /> <br />~-cz~ <br />~) ~ ~ - ~--a. - <br /> <br />ERU <br /> <br />Prepared By <br /> <br />Checked 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 <br /> <br />RECEIPT NO. <br /> <br />-::::> <br />~ (.....-., ~ -~----....... <br />J 7' J;::7'"DA T~ <br /> <br />~ ,RECEIVED BY ._-:=) <br />/ 1~/~~:3--- CJ-tlC(- <br /> <br />?"'. <br /> <br />(/9{t;) <br />