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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Permit No. ._-,-z::~(!.;2..!.______._ <br />Date Permitted __ 3~_r(_.._C3 _ <br />Builder I\~alne/Owner Name __,._...:.QJ.:....~~':_~'c:.~Q__il~_~~~_____ Control # _________________.__._ <br />COllllty Pal (;ell'I().}_ll:.(;l~~__<>!-J -Jl!C?/Q__Q.-?:JLO(L_JLP C1S2...__ SubDiv: (,,'1f::.tL(:_~.!{QKI.2~L1t~L{/ i) <br />Ad d res s/l_ 0(;8 tlo 11_')'1 ~~~)__:?_ __.~L~_~::~ _ fLQJ5_ \ ~. Q _N___-'JJv.. (l________________ n_______. ~___ <br />Classificatlonl rype of Use _Q~_('~J~~_~Q__.hl 'F~ l_~~:~~:""_...________.____._n_ ______.__________ _._.________ <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Hate: _.___________ Sq Ft Unit: __________._____._ <br /> <br />Exempt [I Yes [;JNo <br /> <br />Ilow Determined <br /> <br />Impact Fee Amount ~_~____.l,.~I~__~~__....1)t'___ <br /> <br />Zone No, TAZ: <br /> <br />-..-.."--,-...... <br />SCHOOL IMPACT FEE <br /> <br />Exempt <br /> <br />(056 ) <br />(057) <br />(058) <br />~t. 'II ~3) <br />~/rYas <br /> <br />Single-Family Detached HOLlse <br />Mobile I-lome <br />Other Residential <br />Collection Fee <br />[] No I-low Detennlned <br /> <br />Arnount $ <br /> <br />Account <br /> <br />PARl<S ANn RECREATION FEE <br />Lalld Accollnt Land Credit <br /> <br />Hecreatiol1 Account <br /> <br />Recreatipn-erEidft <br /> <br />Hecreatlon Total <br /> <br />Zone <br /> <br />..---'-" <br /> <br />TOTAL AMOUNT ._~_.____.._____.__ n_________ <br /> <br />--- <br /> <br />Exernpt J]-Y6S/ [] No <br /> <br />How Determined <br /> <br />'~,:";""..--....---.~,-"-",,,,...............................----,~.......-......--,....._--~................._....... <br />LIBRARY FEE <br />Lanel Accourlt <br /> <br />Land Credit <br /> <br />/ -rand Total <br />.......--.-------:=.---:::=-.. -- _.. <br /> <br />Facility Account_ . __________~______ Fa0I.1~y-Credlr~~_.._.______________. Facility Total <br /> <br />. EX8I1lpt[J Ve!)-'['] N-~ <br /> <br />How Determined Total Amount <br /> <br />RESOURCE FEE <br />TOTAL AMOUN'r <br /> <br />ERU <br /> <br />PI 81 lar-ad By <br /> <br />__ ____.__ ___________ Checl<ecl By <br /> <br />NO GERflFIGATE 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 />AGl\rIowledgernent below does Ilot Imply acceptance of concurrence, but simply receipt of a copy of this form, plaG1nu <br />tlte building permit owner on notice of this assessment and the conditions of paYl1lent for samB. <br /> <br />DATE ! <br />RECEIPT NO. {s,J !:..!~1_ DATE <br /> <br />-- F~ECE IV-EO-S-y---------------------. <br /> <br />BY <br />