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a ; ; _ 'i ji H. PASCO COUNTY, FLORIDA <br /> r 0R1V , : <br /> Permit No. / (� 3 6 <br /> Date Permitted <br /> Builder Name /Owner Name c6cte..k C Sh'i(6 VOYI Control # <br /> County Parcel No. l 26_22- b°10- 03(000- 0000 SubDiv: <br /> Address /Location 4 2 4 1 S' kU D ■ VL 1-a_ r e, <br /> Classification/Type of Use C0 n&Mercr'a M.(,L.( 4; pfkr,pause .au, Y'ytc, <br /> TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: C/ <br /> Exempt LYes No How Determined <br /> Impact Fee Amount $ A)74 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> • <br /> Account (056) Single - Family Detached House Amount $ /O j+}- <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes No How Determined <br /> PARKS AN RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ /OM- <br /> Exempt . Yes E N o How Determined <br /> LIBRARY F E <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ►`;I es E No How Determined Total Amount N //4- <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By � . ! riV Checked By <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. DATE BY <br />