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.,. , <br /> .,, <br /> �. ,,, <br /> ;� �� �,; i pA�CO COUNTY, �LOF�IDA <br /> � ; . <br /> Permit No, l ` � 5 _ <br /> Date Permitted • �-- .�zs- � ( <br /> Builder Name/Owner Name L.��E' +�i �1 A r ��`e S�� Control #' <br /> County Parcel No. <br /> b 3 26-2 � — jSZ�O -����—���ASubDiv; I a <br /> Address/Locatlon 3� 7 � S � � � � n "`�" � � � � � <br /> ' � �b���� <br /> Classification/Type of Us� �'.�1�1 �- - <br /> 1`RANSPORTATION IMPACT FEE � Rate: Sq Ft Unit; �J`' � L_____ <br /> Exem�t [� Yes ❑ No HoW Determined <br /> � Impact Fee Amount $���� � Zone No. T�� <br /> SCHOOL IMPACT FEE <br /> Acccunt (056) Single-Family Detached House Amount $ �� S?'�� <br /> (OS7) Moblle Home <br /> (058) Other Residentia) <br /> 123) Collectior� 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 $ � �O ( ' �1� <br /> Exempt � Yes Q No How Determfned <br /> LIBRARY FEE <br /> �.and Account L.and Credit Land Total. <br /> Faciilty Account Facll�ty Credit Faclllfy Total <br /> Exempt � Yes ❑ No How Determined Total Amount --� <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT ' <br /> Prepared By ' Checked sy <br /> NO CER7IFICATE OF OCCUPANCY WILL BE (SSUED �R FINAL INSPECTIpN <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A��:NTRAL PERMITTINC3 O�=FIGE OF PA8C0 COUNTV <br /> Acknowledgement below doea not imply acceptance of concur�enpe, but slmply recelPt of a copy of thfs form, plaaing <br /> the bullding permit owner on notice of this assessment and th� conditlons of pa�ment for same. <br /> DATE R�CEIVEQ BY <br /> RECEIPT NO. DATE BY <br />