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PASCO C®UNT'Y, FLORIDA <br /> Permit No. r y _ <br /> Date Permitted c5_46 <br /> Builder Name/Owner Name 'Le,/X a r- �`l`� Control# ' <br /> County Parcel No. <br /> o<Oa(,04-03 SubDiv: __ <br /> Address/Location (p('P_S3 LJ� t kA, <br /> rr r <br /> Classificationffype of Use S tl l P �L1 <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: , <br /> Exempt []Yes [] No How Determined <br /> Impact Fee Amount $.S632,61) Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (058) Single-Family Detached House Amount $ �19?1 Z <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 $ <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 Amouimt__ , ____ <br /> i <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> i <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 ofa 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 />