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� i� j PASCO COUNTY, �LORIDA <br /> . Permit No, � )�� � <br /> Date Permitted '_ <br /> Builder Name/Owner Name L,�� (��� ��� Control # <br /> I J �� l C)u9n �tCYi-�P�' <br /> County Parcel No. <br /> p 3_ Zlo -- 2( -- G 250- OCX�} I �Div: I7 , a�r� <br /> Address/Location � � � 0 . r � � � 2 <br /> Classification/Type of Use �� � � l � �Q ��� � �� <br /> TRANSPORTATIOM IMPACT FEE � Rate: � 7•�5 Sq Ft Unit; �, I� I <br /> Exempt [] Yes � No Haw Determined <br /> Impact Fee Amount $ �J � U�' � Zone No. T�� �--- <br /> SCHOOL IMPACT FEE I — 7 <br /> Account (056) Single-Family Detached House Amount $ t�� ('�Q <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt � Yes [� No How Qetarmined <br /> PARKS AND RECR�ATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recfeation Credit Recreation Total <br /> Zone TOTAL AMOUNT $� l0 !• S� <br /> Exempt ❑ Yes � N� How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facllity Total <br /> Exempt � Yes ❑ No How Determined Total Amount �_ <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT � <br /> Prepared ey • Checked Sy <br /> NO CERTIFICA7E OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIpN <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenos, bui slmply recelpt of a copy of thls form, placing <br /> the building permit owner on noUce of ihis assessmenl and tha conditions of payment for same. <br /> QATE RECEIVEp BY <br /> RECEIPT NO DATE By <br />