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� �. PASCO COUNTY, FLORIDA <br /> • � Permit No. � /Z-� �� <br /> Date Permltted <br /> Builder Name/Owner Name � e�2�la � �Ps � LC Control # <br /> County Pafcel No. � � - Z 6 • Z � - �S ZSb-- (� j�0(�- ( 2 �pSubDiv: �� / �� � r � <br /> Address(Location �0 3� p L.���Q �-C� L.,�� �� 2 "� <br /> Classification/Type of Use �' �� h���' <br /> TRANSPORTATION (MPAGT FEE , Rate: I�� 5 Sq Ft Unit; � <br /> Exempt � Yes � No HoW Determined <br /> � Impact Fee Amount $��� �� � Zone No. TAZ: <br /> SCHOOL IMPACT FEE ! � 5 %7 _ � /� <br /> Account (056) Single-Family Detached House Amount $ � 7� _ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Coliection Fee <br /> Exempt [� Yes �] No How Determined <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 b q° S�p <br /> Exempt [� Yes � No How Determined <br /> LIBRARY F�E <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount ��� <br /> RESOURCE FEE Ef2U <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 /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenae, hut slmply recelpt of a copy of ihls form, placing <br /> ihe building parmit owner on notice of ihls assessmenl and the conditlons of payment for same. <br /> pATE R�CEIVEQ BY <br /> RECEIRT NO DATE gY <br />