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t i <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted 10-f5 A j <br /> Builder Name/Owner Name a C . Control#' <br /> County Par4el No. ubDiv: Za <br /> 4 Address/Location © �t <br /> i Ciassiftcation/Type of Use J� Y VA <br /> M i <br /> E <br /> TRANSPORTATION IMPACT FEE URate, Sq.Ft Unit: 2 i 3rP 2- <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $.3) Zone No. TAZ: <br /> i <br /> 1 SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ 05,2-13 <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 /> �� <br /> Zone TOTAL AMOUNT $ -7 t` <br /> 516 <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 the conditions of payment for same. <br /> I <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />