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;� `: PASCO COUNTY, FLORIDA <br /> Permit No. � � � �" o <br /> Date Permitted <br /> euilder Name/Owner Name �� ►'1 11�--� [�i G r►' `� S Control # <br /> County Parcel No. (� g�Zb -Zl' d'�JG-�l.�.v 1�7�ubDiv: �� t�- ������ <br /> Address/Location ��p 2 z— � �0�'Gf�61G� � f � L� �/ � <br /> Classification/Type of Use �r� V 1��� 1��l`1�" /G�� <br /> TRANSPORTATION IMPACT FEE � Rate: •/� _ Sq Ft Unit; !�� <br /> Exempt � Yes [� No How Determined <br /> Impact Fee Amount $ J�7 ` C�� Zone No. TAZ: � <br /> SCHOOL IMPACT FEE / '/ <br /> Account (056) Single-Family Detached House Amount $ t� 5,�. 7'D <br /> (057) Mobile Home <br /> (058) Other Residentlal <br /> 123) Collection Fee <br /> Exempt Yes [] No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Rec� Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7��� J� <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amou � <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT � <br /> Prepared By r Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIpN <br /> PERFORMED UNTIL THE TOTAL AMUUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTEb FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenos, hul slmply recelpt of e copy of thls form, plaaing <br /> ihe bullding permit owner on notice of this assessment and th� conditions af payment for same. <br /> QATE R�CEIVED BY <br /> RECEIPT NO DATE gY <br />