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PASCO COUNTY, FLORIDA <br /> Permit No. Z <br /> Date Permitted <br /> Builder Name/Owner Name _ lek+rg oy�51 d -+, Control#' <br /> County Parcel No. SubDiv: ('j"— ?$ <br /> Address/Location _ (x <br /> i Classification(Type of Usq (e `fu rn�lc <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2, t 7 g <br /> Exempt Yes [] No How Determined <br /> Impact Fee Amount �. 3;12. -60 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (058) Single-Famlly Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt a Yes Q No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit -Recreation <br /> /Total <br /> Zone TOTAL AMOUNT $ 7 6 <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 thq conditions <br /> //of�f payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />