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;� � `. PASCO COUNTY, FLORIDA <br /> Permit No. � Z � �9 <br /> Date Permitted <br /> Builder Name/Owner Name G—°-n �r �� Control # <br /> a� t 33D SubDiv: �� K�-'"�C�l r"`�� <br /> County Parcel No. �^ 3�2��2�' ��" ��Od — <br /> AddresslLocation 3 �b � 3 �'� ����'�- ��"� � C � <br /> Ciassificallonlfype of Us� � � t�L ,���� ��� � <br /> TRANSPORTATION IMPACT FEE • Rate: Sq Ft Unit; � r`7 �3 _ <br /> Exempt � Yes � No HoW Determined <br /> Impact Fee Amount � 3`1 (`�6 zone No. T�� <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ���� '� a <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [� Yes �] No How Determined <br /> PARKS AND RECR�ATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT $�(o q� S� <br /> Exempt � Yes � No How Determf�ed <br /> LIBRARY F�E <br /> �and Account Land Credit Land Total <br /> Facility Account Faclljty Credit Facllity Total <br /> Exempt � Yes ❑ No How Determfned Total Amount <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT � <br /> Prepared e ' � Checked 8y <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 PERMIITING O�FICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenae, hut slmply recalpt of e copy of ihis form, placing <br /> the bullding permft owner on notice of thls assessment and tha condlUons af payment for same. <br /> QATE R�CEIVER BY <br /> RECEIPT NO DATE gY <br />