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„, � <br /> �; <br /> ; � <br /> : , ''^ '+,, <br /> ; ; / = P��CO CUUNTY, FLORIDA <br /> Y I. <br /> Permlt No, � � � <br /> Date Permitted - �- � <br /> Builder Name/�wner Name �.'e� ��r � '���- Control # � <br /> County Parcel Na. v ��� r' 2 � ^ �� <br /> � �7�SubDiv: �-i `��� ' `” `� <br /> d ess/Location � � 1 � ��{ � � � �`" ' ��� 6 � ? ' <br /> Ad r <br /> Classiflcatlon/Type of Us@ <br /> �S �'c��e.n`�-i a� E ��� �o�n-�e <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit; �� 3 <br /> Exempt ❑ Yes ❑ No Haw Determined <br /> ' Impact Fee Amount $'J �- �O . Zone No. T�� <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $^ ����•�Q <br /> (057) Mobile Home <br /> (058) �ther Residentiaf <br /> 123) Collection Fee <br /> Exempt [� Yes [] No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Aceount Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ � (o� .,.S <br /> Exempt ❑ Yes [� No How Determined <br /> LIBRARY FEE ^ <br /> �.and Account �and Credit Land Total <br /> Facility Account Facility Credlt Facllify Total <br /> Exempt � Yes (� No How Determined Total Amount _� <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT � <br /> Prepared By � _ Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIQN <br /> PERFORMED UNTII. THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A C�NTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptanc� of concurran�e, hut slmply recelpt of a copy of thls form, placing <br /> the building permit owner on notice of this assessment and tha conditions af payment for same. <br /> RATE R�CEIVEQ BY <br /> RECEIRT NO. DATE BY <br />