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• � , `: - • <br /> • � SCO COUNTY :F <br /> • , i, � PA <br /> • Permit No. <br /> Date Permitted <br /> Builder Name /Owner Name ( / �� ik 'r �/ T-1 B Control # ' <br /> County Parcel No. <br /> Q3 24 -21 -02-3 -p11 ^0316 SubDiv: <br /> Address /Location <br /> 3'1 to 24 /Fr4 /Vfl Rai 61e9 ¥ dt3./ <br /> Classification/Type of Use ti_))i hem& /� 3 �1 <br /> TRANSPORTATION IMPACT FEE . Rate: qt,. U 3 Sq Ft Unit: / I <br /> Exempt [❑ Yes ❑ No How Determined <br /> ( <br /> Impact Fee Amount $ bo Zone No. TAZ: <br /> SCHOOL IMPACT FEE ,/ <br /> Account (056) Single- Family Detached House Amount $ 1 /57 7"b <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt L Yes ❑ No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total 11 <br /> Zone TOTAL AMOUNT $ 7 // OQ .-5 b <br /> Exempt ❑ Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑ Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE . ERU <br /> TOTAL AMOUNT 6 <br /> Prepared By - • 1 'J 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 /> 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 /> DATE RECEIVED BY <br /> RECEIPT NO//66_ DATE /0!d? BY 0,1 <br />