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'• PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> -Builder Name/Owner Name ✓/'rYLLL° Control#' <br /> County Parcel No. Z 100-OORO SubDiv: .uu� <br /> Address/Location . QWJ1-7 e,.Off-96 � 7— 1_71 f1& <br /> ClassificationlType of Use <br /> srz. <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> `< <br /> Impact Fee Amount $. Iq Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home o <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [S] 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 /> r. 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 /> Acknowledgement below does not imply acceptance of concurrence,but simply receipt of-a copy of this form,placing <br /> the bullding permit owner,on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY. <br /> RECEIPT NO. DATE BY <br />