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PA�CO COUNTY, FLORIDA <br /> �� Permit No 1 Z�} 39 <br /> Date Permitted / U ^f Z -!1 <br /> Builder Name/Owner Name F-C,1�1'V - r � e � Control # <br /> County Parcel No. (�.�-� - Z�' ����--���� ZgU SubDiv: L� 14�t �� ���-� <br /> Address/Location J� '] ( Z-7 ��v ✓�� � C1� � � � � — <br /> Classificatlon/Type of Us� /(�iP� (� � �( CC �d �� �vr''�Q <br /> TRANSPORTATION IMPAGT FEE � Rate: � 7� �S Sq Ft Unit: �� 7 �'� <br /> Exempt [] Yes � No HoW Determined <br /> Impact Fee Amount $���I' �°Z Zone No. TAZ: � <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ l 7�� `�O <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 Recfeation Credit Recreatlon Total <br /> Zone TOTAL AMOUNT $� Ga c 'f � S,6 <br /> Exempt � Yes [� No How Determined <br /> LIBRARY FEE <br /> Land Account _ Land Credit Land Total <br /> Facility Account Facfljty Credit Facitity Total <br /> Exempt � Yes � No How Determined Total Amount � <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT � <br /> Prepared By � �� Checked Sy <br /> NO CERTIFICATE 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 O�FICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenoe, but simply recelpt of a copy of this form, placing <br /> the hullding permit owne� on nodce of ihis assesement and th� condlUo�s of payment for seme. <br /> DATE R�CEIVEp BY <br /> RECEIPT NO DATE py <br />