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PASCO COUNTY, FLORIDA <br /> Permit No. 2-0 9 6 7 <br /> Date Permitted 3-l� <br /> Builder Name/Owner Name Control#' <br /> County Parpel No. ()5-2,6-2(-61()D-607CJ0^60(oa SubDIV: (3) nJe� O <br /> Address/Location �, `� c), I fie r-ad O &AcA &?d-b <br /> Ciassification/Type of Use cS AC Je MI <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 7, <br /> Exempt ❑Yes ❑ No How Determined <br /> Impadt Fee Amount $ 3(6,32., Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (0561 Single-Family Detached House Amount $ � �� Z <br /> (057) Mobile Home <br /> (056) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes 0 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�/ <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 ttia conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />