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�; PASCO COUIVTY, FLORIDA <br /> Permit No. � Z <br /> Date Permitted -- 30- ( / <br /> Bullder Name/Owner Name �e✓i n a-'' �� S�� Controi # <br /> County Parcel No. <br /> (� �j- 2(p -2 ( - �2�� - ��L� i `f <br /> Address/Location 37 7 Z- � ��' �- � �� � �� � � ` Z <br /> Classificalion/Type of Us@ ����'e� r� � ( � n ��� <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit; I 3� I <br /> Exempt � Yes [� No HaW Determined <br /> Impact Fee Amount $ 3`� �O � Zone No. TAZ: ,__ <br /> SCHOOL IMPACT FEE / 1 <br /> Account (056) Single-Family Detached House Amount $ �� 5��`t b <br /> (057) Mobile Home <br /> (058) Other Residentlal <br /> 123) Collectio� Fee <br /> Exempt � Yes [� No How Qetermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credlt Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ '7 (��( • �� <br /> Exempt � Yes [] No How Determined <br /> LIBRARY FEE <br /> Land Account L.and Credit Land Total <br /> Facility Account Faciljty Credit Facllity Total <br /> Exempt � Yes �] No How Determined Total Amount �_ <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT ' <br /> Prepared By � � Checked Sy <br /> NO CERTIFICATE UF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIpN <br /> PERFORMEO UNTIL 7HE TOTAL AMOUNTS LIS7ED HAVE <br /> BEEN PAID AND <br /> RECEtPTED FOR BY A CENTRAL PERMITTIN(i O�FICE OF PASCO COUNTY <br /> Acknowledgement below doea not Imply acceptance of concurrenoe, but slmpty recelpf of a copy of thls form, placing <br /> the bullding permit owner on notice of thls assessment and the condidons pf payment for same. <br /> DATE R�CEIVED BY <br /> RECEIPT NO DATE BY <br />