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. ! <br /> ;� '� P�1�C0 COUNTY, FLORIDA <br /> , Permit No, l 2!`? 5 <br /> Date Permitted � - ��� "� <br /> Builder Name/Owner Name ,rf-t GL`.' ( �l �� " l �'� '� Conirol # <br /> County Parcel No. <br /> "j.� �•l7 1 1_ C:�C� i D -�.0 J�, . �� C�c�� subDiv: �:'f�6• y�- c�c m.v«,�; <br /> i��1 <br /> Address/Location 7 � � `� �r �� �� / <br /> Classification/Type of Use �` .�� `G�( ' j`''�"'�C a� C� /n u�' <br /> TRANSPORTATION (MPACT FEE � Rate: Sq Ft Unit: <br /> Exempt � Yes �] No HoW Determined <br /> Impact Fee Amount $ 7� `� � '�' �' Zone No. T�� .-- <br /> SCHOOL IMPAGT FEE <br /> Account (056) Single-Family Detached House Amount $ /JA <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 Recreatlon Total <br /> Zone TOTAL AMOUNT $ ,�; f}, <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Faciqry Credit Facllity Total <br /> Exempt � Yes ❑ No How Determined Total Amount �� <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT � <br /> , 1 <br /> � <br /> Prepared By --. /� � ��-'1� Checked py <br /> �� ' <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 concurrenoe, but slmply recelpt of e copy of thls form, plaqing <br /> the building permit owne� on nollce of ihis assessmeni and th� condlfions af payment for seme. <br /> QATE R�CEIVEQ BY <br /> RECEIPT NO DATE By <br />