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' PAS CO COUNTY, FLORIDA <br /> Date Pwnitte <br /> Bultder Name/Owner Name vta-r ControlWeA-A#' ' <br /> County Parcel No. —Z(e zl—D l Ia-6c�0oo.31`COSubDW: fir-+ <br /> i <br /> Address/Location <br /> ClassiflcationlType of Usq cS"►� <br /> TRANSPORTATION IMPAC EE Rate: Sq.Ft Unit: Z L <br /> Exempt ❑Yes ❑No How Determined <br /> ' 63?► Zone No. TAZ <br /> Impact Fee Amount $. 31 : <br /> � 1 <br /> I � <br /> SCHOOLIMPACTFEE �g <br /> Account (058) Sln®te•Fe ly Detached House Amount <br /> (057) Mobile Home <br /> (055) Other Re ential <br /> 123) Collection Fee A <br /> Exempt Yes ❑No How Determined <br /> PARKS AND RECREATION EE <br /> l ; <br /> Land Account Land Credit Land Total it <br /> Recreation Account Recreation Credit -Recreation Total w <br /> Zone TOTAL AMOUNT $ <br /> • I <br /> Exempt ❑Yes ❑No How Determined <br /> UBRARY FEE <br /> Land Account Lend Credit Land Total j <br /> Facllity.Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑No How Determined Total Amoun�_ I <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Chocked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUEDAR FINAL INSPECTION <br /> PERFORA ED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> I BEEN PAID AND, <br /> RECEIPTED FOR I <br /> Y A CENTRAL PERMITTING OFFICEOF PASCO COUNTY <br /> Acknowtedaement below dome n t Wpty acoeptenoe of eoncurconca,but a:*receipt ate copy or this fomr,pladna <br /> the building permit ow f on notke oI tMe asseesmant erg the condltloM of payment for same. <br /> DATE RECEIVED BY " <br /> RECEIPT NO. DATE BY <br />