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PASCO COUNTY, FLORIDA <br /> T , <br /> Permit No. <br /> Date Permitted -2_3� <br /> Builder Name/Owner Name �y� 9),Ke8 XC. Control#'- <br /> County Parcel No. (3cfl s�(o L/�l�(Sro-filfJd—= SubDiv: <br /> f 1 <br /> Address/Location 79A1 S <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft,Unit: 2&71s' <br /> i <br /> Exempt ❑Yes ❑ No How determined <br /> I <br /> Impact Fee Amount $. f2c�2°� Zone No. TAZ: <br /> I <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount <br /> (057) Mobile Home i <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [j Yes [:] No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total I <br /> i. <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 70-4� <br /> i <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 < i <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 /> f <br />