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;� � .: PASCO COUNTY, �LORIDA <br /> � Permit No. � Zl � g <br /> Date Permitted <br /> euilder Name/Owner Name l..o n f1a-• ['t� ►''+'�2 Control #' <br /> County Parcel No. �3 -Z (� -Z-( - 0 23a-�C�-�q� sub�iv: f P� <br /> AddresslLocation �M�'�- � �"� 1 � � � � <br /> Classiflcatlon/Type of Usg QC?�i��d-� �� � <br /> TRANSPORTATION IMPAGT FEE � Rate: Sq Ft Unit; 3 <br /> Exempt [] Y�s [� No How Determined <br /> Impact Fee Amount $.� �v _ Zon,e No. TAZ: <br /> SCHOOL IMPACT FEE � <br /> Account (056) Single-Family Detached House Amount $ j 7 57• �� <br /> (057) Mobile Home _ _ <br /> (058) Other Residential <br /> 123) Collectio� Fee <br /> Exempt Yes �] No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreatlon Account Rec�eation Credit Recreatlon Total <br /> Zone TOTAL AMOUNT $ � p � 5� <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> �and Account land Credit Land Total <br /> Facility Account Faciljty Credit Facllify Total <br /> Exempt � Yes [] No How Determined Total Amount �_ <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT • <br /> / <br /> Prepared ey� " Checked Sy <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 PERMITTINfi O�FICE.OF PASCO COUNTY <br /> Acknowledgement below doea not Imply acceptance of concurrenoa, but s�mply recelpt of a copy of ihls fonn, placing <br /> lhe building permit owner on notice of thls assessment and fhd condlUons pf paymenl for same. <br /> DATE R�CEIVER BY <br /> RECEIPT NO. �_ pqTE BY <br />