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PASCO COUNTY, FLORIDA <br /> "�F npIt No. �- <br /> Date Permitted <br /> Builder Name/Owner Name G-tnf,: C�ontrol 1#'. l~� <br /> r county Parcel No. <br /> Address/Location <br /> ClassiBcallonfType of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unil: <br /> 2> � <br /> Exempt D Yes [Q No How Determined i <br /> Impact Fee Amount & Zone No. TAZ: i <br /> I <br /> SCHOOLIMPACTFEE 1 <br /> Account (058)• Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (05B) Other Residential <br /> 123) Collection Fee ,r <br /> Exempt U Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> i Land Account land Credit Land Total <br /> E <br /> Recreation Account Recreation Credit Recreation Totals' <br /> Zone TOTAL AMOUNT $ !�!'✓ . <br /> j <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total i <br /> Facility.Acodunt Facility Credit Facility Total <br /> Exempt ❑Yes ❑No How Determined Total Amount,;0 i <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Chocked 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 OFFICEOF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concufrenco,but amply facelpt ate copy of thlo form,placing <br /> thebutiding permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />