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<br />I I <br /> <br /> <br />PAICO COUNTY, FLORIDA. <br />, Permit No. .....5 DC(/( <br />Date Permitted / /, /- D 5 <br /> <br />Builder Name/Owner Name <br /> <br /> <br />Control # <br />SubDiv: V~ ~ <br />~eT~3~ <br /> <br />County Parcel No. <br /> <br />Address/Location <br /> <br />ClassificationfType of USEil <br /> <br />Sq Ft Unit: <br /> <br />Exempt <br /> <br />TAZ: <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-F nhily Detached House <br />(057) Mobile H me <br />~o ) Other Re Itlential <br />3) Collectio Fee <br />Exempt . Yes D No How Determined <br /> <br />PARKS AND RECREATION F E <br />Land Account Land Credit <br /> <br />Amount $ <br /> <br />Land Total <br /> <br />Recreation Account <br /> <br />Recreation Credit Recreation Total <br /> <br />Zone <br /> <br />TOTAL AMOUNT $ <br /> <br />Exempt DYes D No <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />How Determined <br /> <br />Land Credit <br /> <br />Land Total <br /> <br />Facility Account <br /> <br />Facility Credit <br /> <br />Facility Total <br /> <br />Exempt DYes D No <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />~ 0, <br /> <br />ERU <br /> <br />Prepared By <br /> <br />Checked By <br /> <br />NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br />PERFORME I 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 I Jllly acceptance of concurrence, but simply receipt of a copy of this form, placing <br />the building permit owne. on notice of this assessment and th~ conditions of payment for same. <br /> <br />DATE <br />RECEIPT NO. ~ 1 (Oq <br /> <br />DATE <br /> <br />RE2J!:ED BY <br />, \ - \ lH:6 BY .. lJO L'-'l ~ <br />