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PASCO COUNTY, FLORIDA <br /> Permit No, <br /> f f Date Permitted Z <br /> Builder Name/Owner Name G P�cf l,�r—f or/Jtzg�lsdc Control#' <br /> County Parcel No. ©5-�-2f- ZCYdy�D6—! SubDiv: <br /> Address/Location (P 0 2n <br /> Ciassification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: _ <br /> Exempt �Yes ❑ No How Determined <br /> ,;.. : impact Fee Amount $. r 632 a Zone No, TAZ: <br /> SCHOOL IMPACT FEE rPt/ <br /> Account (056) Single-Family Detached House Amount $ 7 $ 26- <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 -Recreation Total <br /> Zone TOTAL AMOUNT $ `6ni_�kf <br /> Exempt ❑Yes [] No How Determined <br /> LIBRARY FEE <br /> 4; <br /> . Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amoaq <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 thQ conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. - DATE BY <br />