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�: P�4SC0 COUNTY, FLORIDA <br /> • ° Permit No. �`1 � <br /> Date Permitted -/-/3 <br /> Builder Name/Owner Name !�j 1�(�� �>h s�n`��n�`� Control# <br /> County Parcel No. .3`�l S-Z/_ �/c�IC-C��LC�- -3�� SubDiv: �u(C ✓Z<�'► <br /> Address/Location 7G ZS /c l c"� ✓����� � '/"'�� 3`5� <br /> Classificalion/Type of Use /llt'[t) /YI�h��� /�rY►�`� — <br /> . � <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit: 1�/ - <br /> Exempt [] Yes � No HoW Determined <br /> Impact Fee Amount $ 3��3�°�D_ Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (D56) Single-Family Detached House Amount $ /���[�` <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collaction Fee <br /> Exempt Yes � No How Determ(ned <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreatlon Total <br /> Zone TOTAL AMOUNT $ � �]�. �3 <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Faciljty Credit Facility Total <br /> Exempt � Yes ❑ No How Determined Total Amount �� <br /> RESOURCE FEE ERU � <br /> TOTAL AMOUNT <br /> Prepared By /' � ai Checked Sy _ <br /> � i <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 PBRMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgemen►below does not lmply accepfance of concurrenoe,but simply receipl of a copy of this form,placing <br /> the building permit owner on notice of this assessmenl and tha condllions af payment for same. <br /> QATE R�CEIVEp BY <br /> RECEIPT NO DATE gy <br />