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PASCO BOUNTY, FLORIDA <br /> Permit No. d l -- <br /> Date Permute _ � <br /> Builder Name/Owner Name kt1W ULy(A;tfl.s Control W <br /> County Parcel No, OS- '�»� x3�(�(2 dO�d o subbivc 31 040,eA r-6 <br /> Address/Location O—rfm <br /> Classilication/Type of Use• <br /> TRANSPORTATION IMPACT FEE - Rate: Sq.Ft Unit: Jac f�4`ki <br /> Exempt ❑Yes ❑No / Hove Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount. <br /> (0557) Mobile Home <br /> (058) Other Residential <br /> cv� 123) Collection Fee <br /> v Exempt [ Yes [2 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 $ ­7(o 5( <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 n No How Determined Total Antounfql <br /> RESOURCE FEE ERU <br /> 'TOTAL AMOUNT <br /> Prepared By Chocked By <br /> NO CERTIFICATE OF OCCUPANCY 1NILL.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,butslmply receipt of a copy of this form,placing <br /> the bolding permit owner on notice of this assessment and tha conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />