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� � �: PASCO COUNTY, FLORIDA <br /> Permit No. �% ZU 3 j <br /> Date Permikted <br /> Builder Name/Owner Name �� r'I C� ✓��"s �� Control # <br /> County Parcel No. r 3-- Z!� - ��Z�.So ---L�dl70d -(2U0 SubDiv: �i /�'?G� �(l�/2�10�"'"'e- <br /> Address/Location U/ -� �� �.� h d�{ �c�l-1 .L /� � �" � - <br /> Classification/Type of Us� /dC�JYI /1 �'l'� <br /> TRANSPORTATION (MPA�T FEE . Raie: ��- /�� Sq Ft Unit: /, J�3 <br /> Exempt � Yes � No How Determined <br /> � Impact Fee Amount $ �3`��'�, DO Zone No. TAZ: � <br /> SCNOOL 1MPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ��5�� � <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collectlon Fee <br /> Exempt a 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 AIu�OUNT $ r I �O� -s,� <br /> Exempt r] Yes � No How Determined <br /> LIBRARY F�E <br /> Land Account l�and Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount --�"— <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT <br /> Prepared By � c Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE 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 Gelow does not lmply acceptance of concunenae, but slmply recelpt of a copy of this form, placing <br /> the building permit owner on nollce of ihls assessment and th� condlUons af payment for same. <br /> DATE R�CEIVEQ BY <br /> RECEIPT NO DATE BY <br />