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r <br /> t <br /> I ; <br /> E <br /> PASCO COUNTY, FLORIDA <br /> krgtit No. Z 1 t3S7 _ <br /> Date Peanitte�_ _ <br /> Builder Name/Owner Name r�1`fdmf�8 �C Control#" <br /> County Pafcel No,? 2 - 110^0 0 0 00-00 20 SubDIV: <br /> Address/Locadon t; C/g� <br /> Ciassificadon(rypeofUsg ( 144 4mi•�G <br /> TRANSPORTATION IMPACT FEE Rate: t Sq.Ft Unit - - <br /> r' Exempt O Yes ❑No How Determined <br /> r� r ' <br /> E' <br /> Impact Fee Amount�,3��P 7,Z• � Zone No. TAZ: i <br /> j <br /> SCHOOL IMPACT FEE <br /> Account (058) Single•Famlly Detached House Amount $ 2-6 <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee a <br /> Exempt Yes ❑No How Determined <br /> PARKS AND RECREATION FEE i <br /> r Land Account Land Credit Land Total <br /> 3 Recreation Account Recreation Credit -Recrealion Total „ <br /> Zone TOTAL AMOUNT $ - 6 q` 5, <br /> j <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facillty.Account Facility Credit Facility Total i <br /> Exempt ❑Yes ❑No How Determined Total Amount I <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 acceptancs of concurrence,but almply recolpt of a copy of thle form,placing <br /> the bullding pamtlt owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />