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I• <br /> 1 i <br /> - f <br /> PASCO COUNTY, FLORIDA <br /> Permit No. 2z-� f1 <br /> Date Permitted <br /> Builder Name/Owner Name Control#' . <br /> County Panel No. �3z-Z s`2_(—b jD0- D/ad?-DD((7 SubDIv: <br /> ' Address/Location <br /> Ciassificationtrype of Use 5iAq (� 7�r✓I� <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3��' <br /> Exempt ❑Yes ❑ No How Determined <br /> y- t Impact Fee Amount $. 3/�3 2 Zone No. TAZ: <br /> f SCHOOL IMPACT FEE <br /> E Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> I Zone TOTAL AMOUNT $ <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 _ r 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 />