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PASCO COUNTY, FLORIDA <br /> r Permit No. [ f <br /> Date Permitted <br /> Builder Name/Owner Name L��r1 yt�r`H��'►''�S[_(s._ Control <br /> County Parcel No, SubDiv: IS, <br /> Address/Location S 1 <br /> 'W1a <br /> Classification/Type of Use m j <br /> TRANSPORTATION IMPACT FEE Rate: q.Ft Unit: _Zr 37,� <br /> Exempt ❑Ye's ❑ No How Determined <br /> Impact Fee Amount $. `7 i Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ,� <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 $ �iQ 1,54 <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 Amoun75 _ <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 /> t <br /> RECEIPT NO. DATE BY <br /> { <br />