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I <br /> k: PASCO COUNTY, FLORIDA <br /> Permit No. <br /> `j Date Permitted <br /> Builder Name/Owner Name 1=A&4f 4 10Y YIDS Control# <br /> County Parcel No. <br /> SubDiv: �?� <br /> Address/Location c.32—-7 Z) <br /> R <br /> Classification/Type of Use r <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Zt 57 Z <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $.�`3 Z } 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 /> t <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 <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 4 <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 />