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` PASCO CtJUNTY, FLORIDA <br /> "' Permit No. ���1 3 <br /> Date Permitted -3-z��-�3 <br /> Builder Name/Owner Name ���i���i�'E ✓����'•�2�J�lC Control# <br /> Counry Parcel Na Oz-Zk 7_�- 0�lC'-c,��L'CC-C)L'S0 SubDiv: � y�///'S <br /> Address/Location ��C''�%1 1 r���"��� �Cl�c.+'� <br /> Classification/Type of Use Gt�"y�n� �'Ct r^� � C��ilr �� <br /> TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: l�J <br /> Exempt � Yes � No How Determined <br /> Impact Fee Amount $ Z.�j� �=`� `�;77 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family petached House Amount $ ��� <br /> (�57) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes [] No How Determined <br /> PARKS AND RECR�ATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreatlon Totai <br /> Zone TOTAL AMOUNT $ /�� <br /> Exempt [] Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account �and Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes [] No How Determined Total Amount /Tf�— <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT <br /> Prepared By � Checked Sy <br /> N�CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> REC�IP7ED FOR BY A CENTRAL P RMI ITI'NG OFFICE OF PASCO COUNTY <br /> Acknowledgement helow does not Imply acceptance of concurrenae,6ut slmply recelpt of a copy of this form,plaaing <br /> the bullding permit owner on nodce of this assessment and the conditions af paymant for same. <br /> DATE <br /> R�CEIVEp BY <br /> RECEIPT NO ___ pATE BY <br />