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i <br /> i <br /> PASCO COUNTY,.jLORIDA <br /> Permit No. <br /> I Date Permitted <br /> Builder NamelOwner Name b o 01 .Control#' <br /> County Parcel No. SubDiv: � . <br /> AddressfLocation 3�+ <br /> ClassiticatlonlType of Use 41 +d <br /> TRANSPORTATION IMPACT FEE Rate:' I, Sq.Ft Uriit: Z 3,57 <br /> Exempt ❑Yes ❑No How Determined I <br /> Impact Fes•Amount $. 3,6 3-9 •t Zone Nq_ TAZ: <br /> i <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 [I No -How Determined I <br /> PARKS AND RECREATION FEE <br /> "l Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit i -Recreation Total <br /> Zone TOTAL AMOUNT <br /> Exempt ❑Yes [].No How Determined I <br /> i <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> I <br /> Facility Account Facility Credit I Facility Total <br /> Exempt []Yes ❑No How Determined Total Amount-" <br /> RESOURCE FEE i 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 I ' i <br /> RECEIPTED FOR BY A CENTRAL PERMITTING'OFFICE OF PASCO COUNTY i <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 /> I ' <br /> i <br />