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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Permit No. . /f !-7 r! <br />Date Permitted .~ -~ -) -0 ~ <br /> <br />,J!uilder !,!a~wner Name &Jpo"/ &7: Control # <br /> <br />County Parcel No. li-~~Ia - ::L/ -00/ D - DS~tJO- DO ~ ~ubDjv: <br />914" . (7-/. <br />~~S/ - <;?-- \~,( <br />~ <br />(;/u?-Jd <br /> <br />Address/Location <br /> <br />Classification/Type of Use, <br /> <br />TRANSPORTATION IMPACT FEE Rate: <br />Exempt ~s 0 No How Determined <br />Impact Fee Amount $ Zone No. <br /> <br />Sq Ft Unit: <br /> <br />TAZ: <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />. ~ Collection Fee <br />ExemPt.~ Yes D No How Determined <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br />Amount <br /> <br />$ <br /> <br />Lang.lotal" <br /> <br />.'''....---,.,.--.... <br /> <br />Recr~atiarl-credit <br /> <br />Recreation Account <br /> <br />Recreation Total <br /> <br />Zone <br /> <br />.~.,..p <br />.......,...-... <br />,-",' <br /> <br />TOTAL AMOUNT $ <br /> <br />.,~" <br /> <br />Exempt 0 Yes-"-~D No <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />How Determined <br /> <br />Land Credit <br /> <br />.....,...._-...--'-Land Total <br /> <br />-~,,,,,,,,---""P.....,.....-- <br /> <br />Facility Account f9cUity"Credit <br /> <br />----.~"...,...,..........-'" <br /> <br />Exempt D Y~s,,-~'-ITNo How Determined <br /> <br />-_..~._..-_.......-.----.....,...- <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <br /> <br />Facility Total <br /> <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 />Bt:EN PAID AND <br />RECEIPTED FOR BY A CENTRAL P!:RMITTING OFFICE OF PASCO COUNTY <br /> <br />1/~~J6 <br />DATE <br />RECEIPT NO. (17)?~':;;;~ DATE <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. 7 \ <br /> <br />-, / .. <br /> <br />/}t::~/~/,/:7-) <br />RECEIVE' Y. '? \ <br />'? . / / <br />L/ ~-//l <br />BY .,.'t,f1 '1/;-.... .,:,,/'J-:~ "'. ,-"7 <br />. .{~.) << . (./~~ <br /> <br /> <br />s'.j;3~103- <br /> <br />/ l <br /> <br />') <br />