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PASCO COUNTY, FLORIDA <br /> PerDate Peit o, 7c� <br /> Jj Date Permitted • �ZZ' <br /> Builder Name/Owner Name LQ ^a,, �e-S Control#' <br /> County Parcel No, D5�—?�-mil-fX/0//-��j�i1�SCld--(rG�ot� SubDiv: � <br /> Address/Location sl C rnsr � lss V 9 <br /> i <br /> t <br /> i Ciassification[Type of Use 4v <br /> TRANSPORTATION IMPACT FEE Rate: Sq.R Unit: 31,')zl. <br /> i Exempt ❑Yes ❑ No <br /> How Determined <br /> Impact Fee Amount $. c7 1�O ��V y Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes Q 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 $ 76 <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 recelpt 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 />