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`� PASCC3 COUNTY, FLORIDA <br /> � Permft No. �- � 77 <br /> Data Permitted - (2 - ( <br /> Builder Name/Owner Name F.. e✓l Y� Ct /- `�-r�GYYI'e�.$ Control # <br /> . County Parcel No. (� �-2-� - �—(� �6 -(�0- /ZS� SubDiv: � �a�-r�Gi ��/�k I d'ti� n ��'� <br /> Address/Location �j�] lo �- �J l? eCi rGr� �. PX �+- j ZS <br /> Classification/Type of Us@ ��f,t� v t(� Q � C�� �'(c1Y3't� <br /> TRANSPORTATION IMPACT FEE , Rate: •�� Sq Ft Unit; I J t d I <br /> Exempt � Yes � No Ho�tV Determined _ <br /> Impact Fee Amount $,3 Vt%' ��� Zone No. TAZ: <br /> SCNOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ j f � 5,7 •� <br /> (057) Moblle Home <br /> (058) Other Residentlai <br /> 123) Collection Fee <br /> Exempt Yes [� No How Qetermined <br /> PARKS AND RECR�ATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account ^ _ T Recreatlon Credit Recreation Total <br /> Zone TOTAL AMOUNT $ � (p�- S� <br /> Exempt ❑ Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Tota( <br /> Facility Account Facfljty Credit Fecfllfy Totat <br /> Exempt � Yes � No How Determined Total Amount � <br /> RESOURCE FEE ERU � <br /> TOTAL AMOUNT <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 /> RECEIPTEb FOR BY A CENTRAL ERMII'TING O�FICE OF PASCO COUNTY <br /> Ack�owledgament belaw doea not knply acceptance of concurrence, but slmply recelpt of e copy of this form, placing <br /> ihe hulldinp pennit owne� on noUce oi thls essessment and th� condlUons of peymenl for same. <br /> DATE R�CEIVEp BY <br /> RECEIPT NO �_ DATE BY <br />