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IPASCO COUNTY, FLOR40A <br /> Permit No. �JAW <br /> Date Permitted <br /> Builder Name/Owner Name l-t r L '�' '�'�'�" 41c,Control#- " <br /> .! i <br /> County Parcel No. /-2-J-2-f-.Oc'8o- 560(oco-0376 SubDiv: Z` <br /> AddressiLocation � Z t <br /> ClassilicationlType,of Use cat in, <br /> TRANSPORTATION IMPACT FEE Rate: Sq.FtUnit: 24276 <br /> Exempt n Yes ❑No How Determined <br /> Impact Pee Amount $34 ITO Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Famlty D_atached House Amount $ ` A 12-6• <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt [(]Yes ❑ No How Determined <br /> C PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7 6?6,6 <br /> Exempt Yes []No Haw 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 Amourd*� <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By z _ Chocked 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 bullding permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />