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COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name t 7"S� Control <br /> County Parcel No. ©uo SubDIv: <br /> Address/Location � 52 I't)a� t1PAc cal <br /> " ' ClassiflcationlType of Use c5iny�e <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3,525 _ <br /> Exempt ❑Yes ❑ No How Determined <br /> .i Impact Fes Amount $,2j632.. O 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 <br /> ':- Zone TOTAL AMOUNT $ <br /> Exempt ❑Yes ❑ No How Determined. <br /> c:; <br /> l` LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By 9 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 />