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IPASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted - <br /> Builder Name/Owner Name ; [�}� aL Control#' <br /> County Parcel No. 00-0X)5b SubDiv: I � <br /> F ' t— <br /> Address/Location W 6 9 T /, U <br /> Classiflcation/Type of Use CSi C �,( Z,3 8 <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2- Zk3� <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $. 31 6321 • Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ 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 $ 76 2. c% <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 />