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J <br /> PASCO COUNTY, FLORIDA <br /> Permit No. o <br /> \\ <br /> __ Date Permitted <br /> � N <br /> Builder Name/Owner Name ar-+0Y1 7� Control# j <br /> County Par•,cel No. Z�s- -Z�'�L 00' 2 cy- SubDiv: <br /> Address/Location l0 D 9, -rim I I <br /> Classification/Type of Use S le m, L Z �3 6 2- <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Zr c-% '- <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $ 31 3Z+0 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 d 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 $ '](e q• Sb <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 /> j 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 />