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mk <br /> a, ft <br /> M. OUNTY, FLORIDA <br /> PASCO C <br /> Avt NO. <br /> Date Pwnitted <br /> ' r!DS � <br /> f � Builder Name/Owner Name �1/''f�? Control#' <br /> r County Parcel No. nz-7.�-� d3aa-&aO-Q/1 SubDiv:117) <br /> �n ! <br /> AddressfLocation <br /> s <br /> ClassiticatlonlType of Usy S i <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> ❑ 9 <br /> Exempt Yes ❑No How Determined <br /> � Zone No. TAZ: <br /> Impact Fee Amount �7 <br /> ! <br /> SCHOOL IMPACT FEE / <br /> Account (O80) Mobile am a Detached House Amount $ <br /> (067) Mobile Home <br /> (068) Ottier Residential <br /> 1 M) Collection Fee A, <br /> i <br /> Exempt Yes 0 No How Determined <br /> PARKS AND RECREATION FEE <br /> t Land Account Land Credit Land Total <br /> i ! " <br /> Recreation Account Recreation Credit •Recreation Tottaall <br /> Zone TOTAL AMOUNT <br /> • I <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Lend Account Land Credit Land Total <br /> Facll%f.Acoount Facility Credit Facility Total <br /> Exempt ❑Yes No How Detemilned Total Amount_ I <br /> RESOURCEFEE ERU <br /> TOTAL AMOUNT <br /> Prepared By ' Checked By <br /> ND CERTIFICATE OF.000UPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND' . <br /> RECEIPTED FOR BY A CENTRAL PERmmnN3 OFFICSOF PASCO COUNTY <br /> AcknoMedgement below does not Imply acceptance of concurrence,but elmplyrecelpt Girl copy of thla form,placing <br /> the bWldieg paimil owner on notice of We assessment and Ihs condillone of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />