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PASCO CUUNTY, FLORIDA <br /> r Permit No. � J <br /> Date Permitted <br /> Builder Name/Owner Name <br /> ��vkey� C'.�s�- __u��J�ontrol # <br /> County Parcel No. <br /> ��JJ�2u'Zl j�010—p�70O-(�ONSubDiv: Z� `l �" a� <br /> AddresslLocation j 7 5l 7�5 y �� �� "" /" '-' <br /> Classification/Type of Us@ � �'+� �'ieri�� L - �e9 7���'� � <br /> TRANSPORTATION IMPACT FEE , Raie; Sq Ft Unit: 2� �° <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $/� z � 5 =`s� Zone No. T�� <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ � <br /> (057) Moblle Home <br /> (058) Other Residentlai <br /> 123) Collectlon Fee <br /> Exempt � Yes �] No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ , �t� <br /> Exempt ❑ Yes ❑ No How Determined <br /> LIBRARY FEE <br /> L.and Account �and Credit Land Total <br /> Facility Account _ Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount f �� <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT � <br /> Prepared By Checked Sy <br /> C <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTI�N <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 concurren�e, hut slmply receipl of a copy of thls form, placing <br /> the building permit owner on notice of thls assessment and the conditlons of paymenl Tor same. <br /> DATE R�CEIVED BY <br /> RECEIPT NO DATE BY <br />