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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />, . " Permit No, ___~ iZ1 _ <br />Date Permitted -/.tl-~ <br /> <br />'- BuilderNam~!OwnerName ~;$-.5jt(control# ~._..~_. <br /> <br />COllnty Parcel No. J1j'.:M:-~~o'Ji> -lu)c)~-/~Q SubDlv: ~ <br /> <br />Address/Location --~2Jz.tJ-!t--~1L tb _. ._____________ <br /> <br />Classiflcatlon/Type of Use ._____ <br /> <br /> <br />-----.----------------.----.-".-- <br /> <br />TRANSPORTATION IMPACT FEE Rate: _ Sq Ft Unit: _~______ <br />- Exernpt [.I Yes 1>.s(NO How Determined _______________.___________________ <br />Impact Fee AllloUllt__~_J,5:.BF!~/sjoj Zone No, TAZ: _________________ <br /> <br /> <br />_..a.....- <br />.SCIIOOL IMPACT FEE <br />Account (066) Single-Family Detached I-louse <br />(057) Mobile Home <br />(058) Other Residential <br />\ 1~23) Collection Fee <br />Exempt ~ Ves [J No How Determined -'~~.k.L5f!~ <br /> <br />PARKS Ar-:m RECREATION FEE <br />Land Account Land Credit <br /> <br />Amount <br /> <br />$ <br /> <br />---._._~-~...._~_.-_.-- <br /> <br />~---_..._--.----_._.__.....---...._---_.- <br /> <br />___.4__.~______.._,~_.___~ <br /> <br />------. -'~-"'----- <br /> <br />Land Total <br /> <br />----_...__._-_._---~ <br /> <br />Recreation Account <br /> <br />Recreation Credit <br /> <br />Recreation Total <br /> <br />Zone <br /> <br />TOTAL AMOUNT -._L_____.__________________ <br /> <br />Exernpt [I Yes [] No <br /> <br />How Determined <br /> <br />----------_._---,_._--_._~----,_.._- <br /> <br />Iis'RARY FEE~~"--._--- <br />Land Account Land Credit <br /> <br />Land Total <br /> <br />--_.~-------.__._--- <br /> <br />Facility Account ____________ Facility Credit __________ Facility Total .________ <br /> <br />Exempt [] Yes [J No <br /> <br />How Determined Total Amount <br /> <br />----- ---------- <br /> <br />RESOURCE FEE ~ <br />TOTAL AMOUNT __~~_______ <br /> <br />~-- <br /> <br />ERU <br /> <br />--_._-----~-- <br /> <br />-.--.....-..--- <br /> <br />-' ----- <br /> <br />Prepared By ______-'-___________________ Checked By <br /> <br />--..--.-----.---.- <br /> <br />NO CERTIFICATE OF OCCUPANGY WILL BE ISSUeD OR FINAL INSPECTION <br />PERFORMED UNTIL 'fHE TO.fAL AMOUNTS LISTED HAVE <br />BEEN PAID AND <br />RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> <br />AGlmowledgernenl below does 1I0t 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 paynlent for same, <br /> <br />--.....--.-------.--------..----.-- <br /> <br />DATE <br /> <br />RECEIVE613'(""------------ <br /> <br />RECEIPT NO, UJO--:LUa-_ DATE ~\. - :=\_::::.~ BY <br /> <br />W'~ . <br /> <br />-_._,.~~_._~-------_._-,-----_. <br />