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i <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted /--7-3� <br /> Builder Name/Owner Name [ "r Control#' <br /> County Papoel No. /db30- ( C),g_ Ol0 SubDlv: . (71 <br /> ` r <br /> Address/Location ZZZb J& <br /> Classificatlon/Type of UseQ/ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes n No How Determined <br /> Impact Fee Amount $. Abs da Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (0561 Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt a Yes Q 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 $ ���•d6 <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 Amounf=Le� <br /> RESOURCE FEE , ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> i <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 />