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' PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted --' <br /> Builder Name/Owner Name C.dt�1�7 Control#' . <br /> County Parcel No. SubDiv: '0jntLT—QW_ <br /> ;s. <br /> Address/Location - � 133 vLi rl <br /> Classification/Type of Use �IP <br /> t TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: � <br /> Exempt `❑Yes ❑ No How Determined <br /> ' impact Fee Amount aJ v V Zone No. TAZ: <br /> 3 <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ G <br /> (057) Mobile Home <br /> (058) Other Residential <br /> y`{ (123) Collection Fee <br /> Exempt H Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit -Recreation Total <br /> Zane TOTAL AMOUNT <br /> Exempt ❑Yes ❑ No How Determined <br /> 4� iv LIBRARY FEE <br /> - Land Accounf Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> r, <br /> Exempt ❑Yes ❑ No Haw Determined Total Amount-_ ��` <br /> RESOURCE FEE ERU <br /> ' TOTAL AMOUNT <br /> Prepared By Checked By <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 PERMITTING OFFICE.OF PASCO COUNTY <br /> , <br /> ri 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 RECEIVED BY. <br /> RECEIPT NO. DATE BY <br />