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i <br /> PASCO COUNTY, FLORIDA <br /> �1 �; r Date Parmlited� <br /> Builder Name/Owner Name <br /> 0tA4 " 4;ontrol#' <br /> County Pamet No. <br /> Address/Location <br /> CiassiticatlontType of Us$ cSa t� r <br /> TRANSPORTATION IMPACT FEE Rate: Sq.R Unit: —<...... <br /> Exempt ❑Yes ❑No How Determined <br /> /� 7 Zone No. TAZ: <br /> Impact Fee Amount j <br /> i <br /> SCHOOL IMPACT FEE <br /> Account (058) Single-Famlty Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collecllon Fee <br /> Exempt [�Yes 0 No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> i ` 2 <br /> Recreation Account Recreation Credit .Recreation Tonal <br /> Zone TOTAL AMOUNT $ <br /> j <br /> Exempt ❑Yes []No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Facttity.Account Facility Credit Facility Total <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 socepw"of concurrence,but ahr*receipt ota copy of thla roan,plocing <br /> the buWhvpsmdt owner sit notion of this assessment and the cor4donsof payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />