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�� : PASCO COUNTY, FLORIDA <br /> ,� <br /> Permit No. �yC7�jZ <br /> Date Permitted _��j2 /3 <br /> Builder Name/Owner Name ,�_�,�L��,��Q� �,,,�//�Control# <br /> —(�_=�- <br /> CountyParcelNo. D�-7J,_Zf_ oG6�,��p�� a�2� �' J� �� <br /> SubDiv• , �-a <br /> AddresslLocation 3�p z� �``.�R�_,y ����� �p �� � �L <br /> Classification/Type of Use _ j�� (.� �m r (y <br /> TRANSPORTATION IMPACT FEE � Rate. <br /> ��� v Sq Ft Unir 7`f_�3?_ <br /> Exempt � Yes [� No How Determined <br /> �mpact Fee Amount $ 3(c 3Z Zone No. <br /> ______ TAZ. <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount <br /> (057) Mobile Home $ ����' �� <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes [�,�No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit <br /> Recreation Total <br /> Zone TOTAL AMOUNT $ `����5� <br /> Exempt (� Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit <br /> Land Total <br /> Facility Account _____ Facility Credit <br /> Facility Total <br /> Exempt [] Yes [� No How Determined <br /> Total Amount � <br /> RESOURCE FEE <br /> TOTALAMOUNT ERU <br /> Prepared By Y Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE 70TAL AMOUNTS LISTED HAVE <br /> RECEIPTED FOR BY A CENT ALEP RMI ITT NG OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence,but simply receipt of a copy of this form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE <br /> RECEIVED BY <br /> RECEIPT NO ____._ pATE �_ BY <br />