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C� <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted —AIL/I <br /> BullderName/Owner Name J,&Wer- 1%M0'J11e_ Control#' <br /> County Parcel No, SubDiv: &Jve o <br /> Address/Location <br /> Classification/Type of Use Tm Ale 4-'w- %,013 <br /> L/ I <br /> TRANSPORTATION IMPACT FEE Rate: Sq-Ft Unit: <br /> Exempt n Yes [] No How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ z <br /> (057) Mobile Home <br /> (058) Other Residential <br /> (123) Collection Fee <br /> Exempt F1 Yes n 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 $ Z61 <br /> Exempt []Yes ❑ No Howaetermlned <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt F1 Yes Fj No How Determined Total Amount <br /> RESOURCE 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 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 />