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PASCO COUNTY, FLORIDA <br /> PermltNo. .20'760 <br /> Date Permitted <br /> Builder Name/Owner Name Control W <br /> County Par..cel No. SubDIV: <br /> Address/Location kves" ke- <br /> ClassiflcatlonlType of Use cam. 2-, 3?Z <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2t 3 7 Z <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $. 3��e 3 2 Zone No. TAM <br /> SCHOOL IMPACT FEE Z� <br /> Account (056) Single-Family Detached House Amount $ D <br /> 9 .(057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [ 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 $ '7(05• � <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 />