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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> /,, <br /> Date Permitted <br /> / <br /> Builder Name/Owner Name 6.P�i_/ll�r"16101 eV Control# <br /> County Par,.cel No. O� — -f I�CLi�Z>-tSUDiv: <br /> Address/Location '3 6-9 , / <br /> ClassiflcationRype of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3i O'zl <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $. Ji�P3� v� Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ z <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt d 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 $ �5'6 <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 Amoudc_D <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 />