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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Builder Name/Owner Name <br /> <br />fu~ Tvwe Sf ~ <br /> <br />Permit No. 3'1 /.., 'f <br />Date Permitted lc/f--O S <br /> <br />Control # <br /> <br />County Parcel No, <br />Address/Location L4'~;3 \ r*- 5T <br />ClassificationlType of USl? Thf21 &)C. <br />TRANSPORTATION IMPACT FEE, Rate: <br />Exempt D Yes ~ How Determined <br />Impact Fee Amount $ rz '2 t( '" iJ/O Zone No. <br /> <br />SubDiv: <br /> <br />Sq Ft Unit: <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.:123) C~ion Fee <br />Exempt U Yes k1 No How Determined <br /> <br />~~ND RECREATION FEE <br />an ccount Land Credit <br /> <br />Amount $ <br /> <br />3ltl.~ <br /> <br />Land Total <br /> <br />Recreation Account <br /> <br />Recreation Credit Recreation Total <br /> <br />TOTAL AMOUNT $ 7~9~ S, <br /> <br />Zone <br /> <br />Exempt DYes D No <br /> <br />How Determined <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />Land Credit <br /> <br /> <br />Land Total <br /> <br /> <br />Facility Total <br /> <br />DNa <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <br /> <br />ERU <br /> <br />?,u<i$S-- <br /> <br />,IL} <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 />RECEIPT NO. <br /> <br />RECEIVED BY <br />, <br />BY fJJ. llM.M. <br />. - <br /> <br />DATE <br />