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;: PQ►SCO COUNTY, FL�RIDA <br /> ' Permit No. 1#�7�3� <br /> Date Parmitted <br /> Builder Name/Owner Name �e��'Jar � � �iC Control # <br /> Counry Parcel No. l�-_3 lW - Z�-Q Z5o -OL�O0 -/Z! U SubDiv: �� n�� <br /> Address/Location �03 Sp !,�`�<�� ��� � � }�" /Z/ <br /> Ciassfficailon/Type of Use �Lt,�ri n� � <br /> TRANSPORTATION IMPACT FEE . Rate: 7�J• 7S Sq Ft Unit: ��ro.3 <br /> Exempt [] Yes [� No HoW Determined <br /> Impact Fee Amount $ �� �0 • Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ��]S '�- � O <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes [] No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit La�d Total <br /> Recreation Account Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT $�] b�I- S(, <br /> Exempt � Yes � No How Determined <br /> LIBRARY F�E <br /> �and Account Land Credit Land Total <br /> Facility Account Faciljty Credit Facflity Total <br /> Exempt � Yes � No How Determined Total Amount _�� <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By ' , - � Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TO�'AL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below doea not Imply acceptance of concurrenae, but slmply recelpt of a copy of thiS fo�m, plaaing <br /> lhe building permit owner on notice of this assessment and tha conditlons of paymenl for same. <br /> DATE R�CEIVEI] BY <br /> RECEtPT NO �_ pqTE gy <br />