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s <br /> . PASCO COUNTY, FLORIDA <br /> r <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name Control# <br /> County Parcel No. � SubDiv: 1 ,?ddefl Address/Location SO:& L�,,_Af` b�ka t <br /> Classificationrrype of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: zt 6D5_ <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $. 3 t 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 Q No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total f <br /> Zone TOTAL AMOUNT $ -7.(tt�•�kj <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 ` G <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 />