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PAS <br /> CO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted /-7-3 <br /> Builder Name/Owner Name <br /> Control# <br /> County Parcel No. — G—6 D — �y�,6 SubDiv: tf& <br /> Address/Location 2 77 <br /> Classificationrrype of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: -- -----� <br /> Exempt ❑Yes [] No How Determined <br /> Impact Fee Amount $. f 57 0 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <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 $ <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 Amou <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 some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />