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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Permit No. ------.Lf'tJ J./ <br />Date Permitted 1- ~&- D3 <br />Builder Name/Owner Name rL. /l1;f ;Jar ~N~ffControl # <br />County Parcel No, If.:g,-,;2(-DJibo <-?.vorv,- o.5C:.D SubDiv: 0J4N~ 0-1"-. <br />Address/Location $~) /(~- ~ fry ~/a~ <br />Classification/Type of Use L-;JJ?.JJ...e _ ~~ <br /> <br />TRANSPORTATION IMPACT FEE Rate: <br />Exempt 0 Yes ~NO How Determined <br /> <br />Sq Ft Unit: <br /> <br />Impact Fee Amount $ <br /> <br /> <br />one No. <br /> <br />TAZ: <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />J.:123) ~ction Fee <br />Exempt lJ Yes ~J No How Determined <br /> <br />Amount $ <br />~ /R7~-- <br />jP.:t S3 ~~ ~ <br />. r"~7 <br /> <br />"-,-/ <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br />Land Total <br />..- ~.--- _..-' <br />..-.._"~ <br /> <br />Recreation Account __~__ ~1t:~n_9fisJll'-'--"-'- Recreation Total <br />Zone /.J'!.. TOTAL AMOUNT $ <br /> <br />Exempt 0 Yes _.-..G-fj-;.... How Determined <br /> <br />.,........-,...,..~.".,.......-"" <br /> <br />L1~FEE <br />[:and Account _~ it1edit /_.-.- <br /> <br />Facility Acc~un;---~~'8l1it/'" . <br /> <br />Exempt 0 Yes O.J>I.o-'''/ How Determined <br /> <br />~- <br /> <br />,'.P--'''''''''--- <br /> <br />Land Total <br /> <br />Facility Total <br /> <br />Total Amount <br /> <br />RESOUR<,:J;.fEl{ -1l1.' 1/. r'/ <br />TOD\t-AMOUNT -d L 'f (5 <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 />RECEIVED BY <br /> <br />RECEIPT NO. <br /> <br />DATE <br /> <br />BY <br />