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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name Dk'4aAyv Tom- control# <br /> County Parpel No. 0S_2_&_2j_P10j)_01Z0t)-0110 SubDiv: (31 <br /> Address/Location h..8.61 0ooy, -RA-d T- <br /> \ U <br /> Classificationrrype of Use k 41 rn/ Cf <br /> TRANSPORTATION IMPACT FEE Rate: Sq.FtUnIt: <br /> Exempt E]Yes ❑ No How Determined <br /> Impact Fee Amount 3 -632, A Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ -7 (5 0,T, 2-15 <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) 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 $ 6/6 <br /> Exempt F1 Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility,Account Facility Credit Facility Total <br /> Exempt n Yes ❑ No How Determined Total Amounte�� <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 />