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s' <br /> PASCO COUNTY, FLORIDA <br /> Permit No. 7�J2 <br /> Date Permitted 2— <br /> Builder Name/Owner Name et Control#' t <br /> County Parcel No. l�' -2(— 6j2�1 O�t�pdj }�-,`�(8a/SubDiv: <br /> Address/Location '�7 <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> - Exempt Yes Fj No How Determined <br /> i;.. <br /> Impact Fee Amount $. (pv2. t Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (0561 Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> ' (058) Other Residential <br /> 128) 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 -Recreation rTotal r <br /> Zone TOTAL AMOUNT <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 <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 /> 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 />