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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted — 6 <br /> Builder Name/Owner Name 4r4 Control#' <br /> ` County Parcel No. 5-Z& 2!—C 08b 00(qZ, D 22o SubDiv: 31 <br /> � - Address/Location <br /> Classification/Type of Use re <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> ;v Impact Fee Amount $.�r632-00 Zone No. TAZ: <br /> Gr` SCHOOL IMPACT FEE <br /> Account (056) Single-Famlly Detached House Amount $ <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 Amount/ <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 /> �V _ <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 />