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; � � � : �A CO COU�dT'Y, FLORID�4 <br /> Permit No. ��js'J/ <br /> Date Permitted ��/S/�! <br /> Builder Name/Owner Name l�.U.r I -!/��1 Control# <br /> County Parcel No.��—� -Z�-(�(j 10^CCCGa-G/�r,p SubDiv: ��eNnG� �y'z�s <br /> Address/Location ��7� /�eu�C.Ua� 1S'2� �p;'� �rj <br /> Classification/Type of Use �lQ� it/-�tv j�S Xs(�.(� <br /> TRANSPORTATION IMPAC FEE Rate: Sq Ft Unit: <br /> Exempt � Yes � No How Determined <br /> Impact Fee Amount $ �� Z• Zone No. Tp,Z, <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-F mily Detached House Amount $ � <br /> (057) Mobile H me � <br /> (058) Other Re idential <br /> 123) Collectio Fee <br /> Exempt Yes � No How Determined <br /> PAR6(S AMD RECREATION EE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ ��3- T 3 <br /> Exempt � Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount -�J <br /> RESOURCEFEE ERU <br /> l'OTAL AMOUNT <br /> Prepared By � Checked By <br /> NO CERTIFICATE O OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORM D UNTIL 7HE 70TAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR B A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not mply acceptance of concurrence,but simply recelpt 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 RECEIVED BY <br /> RECEIPT NO. DATE BY <br />� <br />