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PASCO COUNTY, FLORIDA <br /> _ Permit No. . / 6 10 <br /> Date Permitted <br /> Builder Name/Owner Name L Z A^A r' Me'/-'tC /Control#' <br /> County Parcel No. 2�—Z(0-21-61M--MOD-1170 SubDly: lr9vlkl� A191 <br /> Address/Location 3t 20 Al b ke- <br /> Classification/Type of Use r\/'t 0 <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: 21 Z 74 <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $. �j c3 Z. Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056). Single-Family Detached House Amount $ 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 $ 56 <br /> Exempt R 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 Amodivi <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By r 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 /> ------------- <br /> DATE RECEIVED,BY <br /> RECEIPT NO. DATE BY <br />