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•• t <br /> 1 \ ,��' <br /> � ;' � :� = RA�CO COUNTY, FLORIDA <br /> Y. . � � <br /> � Permit No. ��' 30 - � I <br /> Date Permitted L 1 � ? <br /> 8uilder NamelOwner Name <br /> ��� ��,-- ��, �� Control # ' <br /> n <br /> County Parcel No, �3 �- Z� -- 21- D 2�30 -�(�� _�7?o SubDiv c Q � <br /> Address/Location �� �� � T�'�-r A- t n� �d �� <br /> Classification/Type of Us� 1�'Css+ �'���� � r�'W � r ��- <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit; _` I� 3 <br /> Exempt ❑ Yes ❑ No How Determined <br /> � Impact Fee Amount $��"�O � Zone No. T�� <br /> SCH�OLIMPACTFEE <br /> Account (056) Single-Family Detached House Amount $ ( � ,? 7 � � � <br /> (057) Moblle Home <br /> (058) Other Residentfal <br /> 123) Collection Fee <br /> Exempt [] Yes [] No How Determined <br /> PARKS AND RECREATION FEE � <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7��� S�o <br /> Exempt [] Yes � Nc� How Determined <br /> I <br /> LIBRARY F�E <br /> l.and Account �.and Credit Land Tota) <br /> Facility Account Faciljty Credlt Facllity Total <br /> Exempt (] Yes [] No How Determ(ned Tatal Amount �— <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT ' <br /> Prepared By Checked Hy <br /> NO CERTIFICATE OF OCCUPANCY WII.L BE ISSUED OR FINAL INSPECTIpN <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTER FOR BY A CENTi RA� RERMITTIN(� OFFICE.OF PASCO COUNTY <br /> Acknowledgement below doea not Imply acceptance of concurrenpe, but simply recelpt of a copy of this form, plaoing <br /> the building permlt owner on notice qf thls assessment and thQ condltions af pa�ment for seme. <br /> DATE R�CEIVEp BY <br /> RECEIPT NO. DATE BY <br />