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. � ` PASCO COUNTY, FLOI�IDA <br /> � Permit No. l y/�7 <br /> Date Permikted <br /> Builder Name/Owner Name ��� ���-i G�� �!n�ac�icRe[-p�Dtrol# <br /> CounlyParcelNo. ,3�-Zv-Zl-Of�p- ��UD-- /(� /b SubDiv: ��.,,,� };�3r,�Do7 <br /> Address/Location J� 7�t.3� ���c1 �c� �� �e� /� l <br /> Classification/Type of Use {� 'f'� �T (�t-P <br /> TRANSPORTATION IMPAGT FEE , Rate: Sq Ft Unit; ���� <br /> Exempt [� Yes �] No How Datermined <br /> Impact Fee Amount $ .�(�.31•- 6U Zone No. TAZ: <br /> —� <br /> SCH�OL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ,�L_ <br /> (057) Mobile Home <br /> (058) Other Residentlal <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 Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ S 7�• 73 <br /> Exempt � Yes � No How Determfned <br /> LIBRARY FEE <br /> �and Account Land Credit Land Total <br /> Facility Account Faciljty Credit Facility Total <br /> Exempt � Yes �] No How Determined Total Amount <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT � <br /> Prepared By ! Checked�y <br /> � <br /> NO CERTIFICATE OF OCCUPANCY WILL BE IS3UED OR FINAL INSPECTIpN <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LIS7ED NAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY q CENTRAL PERMITTIN(3 OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Impiy acceptance of concurrenoe,but slmply recalpt of e copy of this form,placing <br /> lhe huilding permit owner on noUce of this assessmenl and th�conditions af paymenl for same. <br /> QATE R�C�IVEQ BY <br /> RECEIPT NO ___ DATE gY <br />