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�: PASCO COUNTY, FLORIDA <br /> Permit No. �' l t 1 <br /> Date Permitted i l � �t � <br /> Builder Name/�wner Name �C'_�i1� r T�''"'�`���C- Control # <br /> County Parcel No. �-3'" ?�� Z�- D Z3o ' C� C�C�A '�7�� SubDiv: �i'� n G� �� � <br /> Address/Location 3 � � 1 � 1�A-r R ��1(1 ��%t � �d � � � � � <br /> Classiffcatlon/Type of Use �'ES+��-��� � ���� <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unft; __ I�5 3 I <br /> Exempt [] Yes ❑ No HoW Determined <br /> Impact Fee Amount $���� . Zone No. T�� <br /> SCHOOL IMPACT FEE <br /> AccouN (056) Single-Family Detached House Amount $ ��� 7� �CL <br /> (057) Moblle Home _ .--�— <br /> (058) other Rasidentfal <br /> 123) Collectio� Fee <br /> Exempt a Yes [] No How Detarmined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7� G I ` S�* <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> �and Account Land Credit Land Total <br /> Facility Account Faciljty Credit Facllity Total <br /> Exempt � Yes � No How Determined Total Amount �� <br /> RESOURCE FEE E�U "'" ' <br /> TOTALAMOUNT ' <br /> , � <br /> Prepared By Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIpN <br /> PERFORMED UNTIL 7HE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING O�FICE OF PASCO COUNTY <br /> Acknowledgemant below does not Imply acceptance of concurrenae, but simply recelpt of a copy of this form, plaaing <br /> the building permit owner o� notice of this assessment and th� condiqons of payment for same. <br /> RATE R�CEIVED BY <br /> RECEIPT NO DATE gy <br />