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PASCO COl1NTl(, LORIDA <br /> Permit No. �/� <br /> Date Permitted — <br /> Builder Name/Owner Name ��n t�/� Control#' . <br /> County Parcel No. 2,6-2fo-_2j--(-)(00— SubDiv: t4,ddeeX(j2r <br /> Address/Location Zg72— <br /> b <br /> tr 35 <br /> ClassificatfonlType of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3 5 <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $. 3 3�, . Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ q(• 2A <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt a 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 thfl conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />