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? PA�CO COUNTY, FLORIDA <br /> ' � Permit No. �:3���C <br /> Date Permitted 2_-z „ -� <br /> 8uilder Name/Owner Name �i q ��CC((�/ �� � Conirol# <br /> Counly Pa�cel No. .��f-Z,S-Z� - _� 1 �c, -OGuDG-,3;Sc._ SUbDiv: �> � Cz�iC�r 7tz�r�2.c1,S <br /> Address/Location .`�'��5 j 9 �G r e c/ ��v r,S 7`1��e. �-t+ _�'�5 <br /> --T <br /> Classification/Type of Use ���'J ��D�� �� �'�� �+ ��� <br /> TRANSPORTATION(MPACT FEE . Rate: Sq Ft Unit; f �� <br /> Exempt ��'es � No How De.termined <br /> Impact Fee Amount $ 3 �,�j� �b Zone No. _ TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Stngle-Family Detached House Amount � /���� <br /> (057) Mobile Home <br /> (058) other Residential <br /> 123) Collection Fee <br /> Exempt a Yes �] No How petermined <br /> PARKS AND RECR�ATION FEE <br /> Land Accoun,t Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ `] ��. '��' <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> l.and Account Land Credit Land Total <br /> Facility Account Faciljty Credit Facility Total <br /> Exempt � Yes ❑ No How Determined Total Amount _ /L���I-- <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared ey � ( u'� <br /> Checked Sy <br /> NO CERTIFICA7E OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL 7HE 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 concurrence,but slmply recelpl of a copy of this form,placing <br /> the building permit owner on notice of thls assessment and th�condidons af paymenl for same. <br /> QATE R�CEIVEp BY <br /> RECEIPT NO DATE gY <br />