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� ;� : PASC4 COUNTY, FLORIDA <br /> Permit No. �/ZD3b <br /> Date Permitted <br /> Builder Name/Owner Name �e�'! r►lc r/�'n e� �� Control #' <br /> County Parcel No. �3 — Z� - D ZSo - C�CX�O - �/��SubDiv: � <�� �J,�/�. <br /> Address/Location G�3�� ��n�''� ���C � � // �/ _ <br /> Classificatlon/Type of Use �Gl�h�'�'i � <br /> TRANSPORTATION IMPAGT FEE . Ra1e: I� �S Sq Ft Unit: /� 9D <br /> Exempt [] Yes � No HoW Determined <br /> � Impact Fee Amount $ 3`{�30 � Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $/ 7 5 7 f�D <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes (] No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Cradit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ '7G �.- $��, <br /> Exempt � Yes � No How Determl�ed <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facllity Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount —d� <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By � Q1�' � Checked Sy <br /> N� CERTIFICA7E OF OCCUPANCY WILL 8E ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL 7HE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement 6elow does not Imply acceptance of concurrence, but slmply recelpt of e copy of ihls form, placing <br /> the building permit owner on notice of ihis assessment and tha conditlons pf paymenl for same. <br /> DATE R�CEIVER BY <br /> RECEIPT NO DATE gy <br />