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PASCO COUNTY, FLORIDA <br /> Permit No.- <br /> Date Permitted <br /> Builder Name/Owner Name �C R��r �� - Control# <br /> County Parcel No. 01,60 SubDiv: `/7 <br /> Address/Location <br /> Classification/Type of Use C�l� !� 7,3 76 7::K— <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2157 <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount O&Z tV Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ 7, r� <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 /> 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 />