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i <br /> f PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name r Control#' . <br /> County Parltel No. 2 y -�/-�bllD��rl_ SubDIv: <br /> Address/Location f 6!� <br /> I Classificatlonrrype of Use <br /> i <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Z> <br /> Exempt ❑Yes ❑ No How Determined <br /> ! I Impact Fee Amount $. 31�v ` Zone No. TAz: <br /> SCHOOL IMPACT FEE --77 <br /> �. Account (056) Single-Family Detached House Amount $ t, <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [1 Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit -Recreation Total <br /> Zone TOTAL AMOUNT $ � ` 56 <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total ��yy <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 bullding permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />