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j PASCO COUNTY, FLORIDA <br /> Permit No. � Z- � ^� � <br /> Date Permftted <br /> eullder Name/Owner Name 1(� Control # <br /> County Parcel No. �3'� - 71 �n�� "���0— (�� SubDiv: �+ I�� ��-+ <br /> � `� '�v.�e ��, �►� l3 �ds� ( 0 l� I 6 0 <br /> Address/Location Z � �t l U <br /> Classificatlon/Type of Usg �()� ��1'1'�'e �-S�`� <br /> TRANSPORTATION IMPACT FEE , Rate: Sq Ft Unit; �?— _ <br /> Exempt � Yes [] No How Determined <br /> Impact Fee Amount $ 3`� �' Zone No. TAZ: <br /> SCHOOL IMPACT FEE 0 <br /> Account (056) Single-Family Detached House Amount $ ^ � �� � � <br /> (057) Mobile Home <br /> (058) Other Residentlal <br /> 123) Collectio� Fee <br /> Exempt Yes [] No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Accoun,t Land Credit Land Total <br /> Recreation Account Rec�eation Credit Recreatlon Total <br /> Zone TOTALAMOUNT $ �J c��j• �Lc, <br /> Exempt [] Yes � No How Determfned <br /> I,IBRARY FEE <br /> l�and Account Land Credit Land Total <br /> Facility Account Facility Credit Facllify Total <br /> Exempt � Yes � No How Determined Total Amount � <br /> RESOURCEFEE ERU ` <br /> TOTALAMOUNT <br /> P�epared By ' � Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> B�EN PAID AND <br /> RECEIP7ED FOR BY A CENTRAL PERMI7TIN(3 O¢FICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence, but slmply recelpt of e copy of this form, placin� <br /> the building permit owner on notice of thls assessment and th� condiqons of paymenl for same. <br /> DATE R�CEIVER BY <br /> RECEIPT NO. _____ pqTE BY <br />