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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Address/Location <br /> <br />Builder Name/Owner Name 0~{) ~ <br />County Parcel No, J i./ - ~S- ;U-O''I 0..08000- ~~,"D <br />37~olf . L~/~ /Jet\ ./1(./'('. <br />ClassificationfType of Us~ ~h//e /~ <br /> <br />Permit No, .' tj 1'77/ <br />Date Permitted 7-/Y-t:) f <br /> <br />Control # <br />/..e'f <br />'). 3 t.~ubDiv: <br /> <br />(9.;b <br /> <br />TRANSPORTATION IMPACT FEE Rate: <br />Exempt D Yes ~ How Determined <br /> <br />Sq Ft Unit: <br /> <br />Impact Fee Amount $ /5o-'g <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />Jj 2;W Collection Fee <br />Exempt LltYes 0 No How Determined <br /> <br />Zone No. <br /> <br />TAl: <br /> <br />Amount $ <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />PARKS AND RECREATION FEE ~ <br />Land Account Land Credit Land Total ./ .. <br /> <br />Recreation Account Recreation Credit Recreatio// <br /> <br />Zone TOTAL AMOUNT Y <br />../ <br />// <br />/' <br />/" <br />/'- <br />Land Credit / <br /> <br />Facility C ~ <br /> <br />Exempt <br /> <br />DYes 0 No <br /> <br />How Determined <br /> <br />Land Total <br /> <br />Facility Account <br /> <br />Exempt 0 Yes 0 No <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <br /> <br /> <br />Facility Total <br /> <br />Total Amount <br /> <br />ERU <br /> <br />Prepare <br /> <br />Checked By <br /> <br />NO CERTIFICATE OF OCCUf>>ANCYWILL 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 th~ conditions of payment for same. <br /> <br />DATE <br /> <br />RECEIVED BY <br /> <br />RECEIPT NO. <br /> <br />DATE <br /> <br />BY <br />