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{ <br /> i <br /> ' PASCO COUNTY, FL ORR A <br /> Plermlt No. Z l L 7 <br /> Date Patmitted-Z- <br /> � IUr`!or ' <br /> i <br /> Builder Name/Owner Name Control#' ' <br /> County Par""cel No. - "bt " p�b �6396Dty: <br /> AddresslLocadon <br /> F< <br /> ClassiflcatlonlType of Uses <br /> r TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Z �� <br /> t; <br /> iExempt ❑Yes ❑No How Determined <br /> impact Fee Amount s 3 <br /> Zone No. TAZ: I <br /> SCHOOL IMPACT FEE <br /> Account {058) SUtgte-Family Detached house Amount $ 7r <br /> (057) Mobile Home <br /> i (058) Other Residential <br /> 123) Collection Fee <br /> Exempt []Yes ❑No How Determined <br /> i; PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit "Recreation Total I <br /> Zone TOTAL AMOUNT <br /> 70 ' � <br /> I <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total 4 <br /> Facllity.Accaunt Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount 4:. i <br /> REFS CE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t 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 PERMtTTiNe 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 an notice of this assessment and the conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />