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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Builder Name/Owner Name <br /> <br />~~ <br /> <br />Permit No, 335/ <br />Date Permitted 'j - 7 - 0 t/ <br /> <br />County Parcel No, <br /> <br />34-;).K'''' ~ t-()090~ Od-m <br />3'7<-t3J (O,r(( /1J~' <br />~~ <br /> <br />. <br /> <br />{f-" 12 { Zo J;1 ~ Control # <br />_f' <br />J.~.' <br />~ l '1" SubDiv: <br /> <br />Address/Location <br />Classification/Type of Use, ~hl {-e... <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Rate: <br /> <br />Sq Ft Unit: <br /> <br />Exempt 0 Yes 0 No How Determined <br />Impact Fee Amount $ (S 'B"f- Zone No, <br /> <br />TAl: <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />J.:1 ~3) Collection Fee <br />Exempt lJYes 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 /> <br />Recreation Total <br /> <br />Zone <br /> <br />$ <br /> <br />TOTAL AMOUNT <br /> <br />ONo <br /> <br />How Determined <br /> <br />Land Credit ---t:and Total <br />F "~ Facility Total <br /> <br />Facility Account <br /> <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />Exempt <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <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 />c" l~:)'()-P BY <br /> <br /> <br />DATE <br />RECEIPT NO. <br />