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PASCO COUNTY, FLORIDA <br /> Permit No. �— <br /> Date Permitte <br /> Builder Name/Owner Name <br /> County Parcel No. 11.Z/v'7/' 40 0- O- SubDiv: <br /> Address/Location t�Sbc� Vj <br /> Classification/Type of Use � S`fP,c[/vo <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: J <br /> Exempt [] Yes [] No How Dptermined <br /> Impact Fee Amount $. 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 $ <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> i <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 the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />