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PASCO COUNTY, FLORIDA <br /> Permit No. � I� <br /> Date Parmitted <br /> Builder Name/Owner Name �P.n,n�� �� �—LC- Conirol # <br /> County Parcel No. � 3�26� ZI - OZ��' CJ(�(�� I ZZQ SubDiv: L�i ce• �r� <br /> Address/Location � 3 J�z �-� nd �� �� � 11 Z — <br /> Classificatlon/Type of Us� ��� ��"� <br /> TRANSPORTATION (MPAGT FEH . Rate: q 7� �� Sq Ft Unit; I, � 6 3 <br /> Exempt [] Yes � No How Determined <br /> Impact Fee Amount $ ��O � Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Famlly Detachad House Amount $ ��.5�� � <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 Credit Land Total <br /> Recreation Account Recreation Credit Recreation Toial <br /> Zone TOTAL AMOUNT $ '�J 6 � • �_ <br /> Exempt ❑ Yes � No How Determined <br /> LIBRARY F�E <br /> l�and Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes ❑ No How Determined Total Amount � <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT � <br /> Prepared By • � - Checked Sy <br /> NO CERTIFICA7E OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIP7ED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenCe, 6ut slmply receipt of a copy of thls form, placing <br /> the 6ullding permit owne� on notice of thls assessment and th� condlUons pf payment for sama. <br /> DATE R�CEIVER BY <br /> RECEIPT NO. DATE BY <br />