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t� <br /> PASCO COUNTY, FLORIDA <br /> Permit No ZD Fff <br /> Date Permitted <br /> Builder Name/Owner Name /i/maix Control#* <br /> o. S <br /> County Parcel N Izz- Z f- ubDiv: f)f <br /> Address/Location <br /> ClassilicationlType of Use <br /> IMPACT FEE Rate, Sq-FtUnit: <br /> Exempt n Yes n No How Determined <br /> Impact Fee Amount �lrYZone 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 $ <br /> g' Exempt []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 Amount.4�/......— <br /> RESOURCE,FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By L/ Chocked By <br /> IV U <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED RAVE <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 copy of this form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE E 'RECEIVED BY <br /> RECEIPT NO. DATE 23 l BY <br />