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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Permit No. i-frXJ '-I <br />Date Permitted '5-::;< :i ~o 5 <br />Builder Name/Owner Name G~ ~ Control # . <br />County parcel No. !YI- ').. !;- 1. I - tH) 90 - Cl;J. '1 tJ j. I[uqolv: (] ( H. <br />Address/Location 3'1 '13& J.. II ~ &c_ AJe, ,,( tJ T / to D <br />Classificationrrype of Us~ yYl.oVJ i Ie. t~- <br /> <br />TRANSPORTATION IMPACT FEE, Rqte: <br /> <br />Exempt 0 Yes ~o How Determined <br /> <br />Impact Fee Amount $. ! _5 S S' Zone No. <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) . Other Residential <br />J.:l2JY' C~e~on Fee ' <br />Exempt l.[YYes ~o How Determln~d <br /> <br />Sq Ft Unit: <br /> <br />TAl: <br /> <br />Amount $ <br /> <br />PARKS AND RECREATION FEE' <br />Land Account Land Credit <br /> <br />L~nd Total <br /> <br />Recreation Account <br /> <br />Recreation Credit <br /> <br />Recreation Total <br /> <br />DYes <br /> <br />~ <br /> <br />TOTAL AMOUNT <br /> <br />$ 5-73',73 <br /> <br />Zone <br /> <br />Exempt <br /> <br />How Determined <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />Land Credit <br /> <br />Land Total <br /> <br />Facility Account Facility Credit <br /> <br />Exempt 0 Yes <br />:::--- . <br />RfsoORCE FEE ' '?JJ1. q \ <br />TOTAL AMOUNT J <br /> <br />___-Faclllty lotal <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 AMOl!NTS LISTED HAVE <br />BEEN PAID AND <br />RECEIPTED FOR BY A CENTRAL PJ:RMITTING OPFICEOF PASCO COUNTY <br /> <br />Acknowledgement below does not Imply acceptance of conc~rrence, but simply receipt of a copy of thll? form, placing <br />the building permit owner on notice of this assessment and thQ conditions of payment for same. <br />. ' <br /> <br />DATE <br />RECEIPT NO. <br /> <br />Dlo7~S <br /> <br />DATE <br /> <br />-=t -2-) rlb BY <br /> <br /> <br />8'~' <br /> <br />