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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> t Date Permitted <br /> Builder Name/Owner Name JGa L�Control#' <br /> County Parcel No, J�?�- Z��.- ZD SubDIV: <br /> Address/Location /9l Z l ai�'i <br /> Classificationrrype of Use wy)`l <br /> _ TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> ? Exempt ❑Ves ❑ No How Determined <br /> Impact Fee Amount $. f; 65 7 Zone No. TAZ: <br /> Gc; <br /> }r <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 E]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 /> z.; <br /> Land Account Land Credit Land Total <br /> X. <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 /> t. 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 />