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PAS O COUNTY, FLORIDA <br /> .�\ P�7rNt No. 2S <br /> Date PW,10.fl <br /> Builder Nam®!Owner Name Control#' ' <br /> I County Pafcal No. - '�"v�TO�6U 'Lrt rr�ubDiv: <br /> Address/Location �0 r <br /> ClassificationRype of Usq Si YL tie <br /> 4 TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: D5 <br /> Exempt ❑Yes ❑No How Determined <br /> Impact Fee Amount $ 3i 63a'//U Zone No. TAZ: <br /> SCHOOL IMPACT.FEE � <br /> Account (OffB)' SIMle•F ly Detached House Amount S /'i UU h�2U <br /> (057) Mobile HC me <br /> (055) Other Re,ildentlal <br /> 23) Collectlar i Fee <br /> { Exempt 6 Yes ❑No Now Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit .Recreation ToW ��yy <br /> Zone TOTAL AMOUNT <br /> • I <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Faculty Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑No Now Determined Total Amouni _ I <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE C F OCCUPANCY WILL 9EISSUED.OR FINAL INSPECTION <br /> PERFO ED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> .BEEN PAIOAND'' <br /> _ RECEIPTED FOR Y A CENTRAL PERMITTING OFFICEOF PASCO COUNTY <br /> Acknowledgement below done ru 4Imply accep{enoe of wncurrence•Cut elmply reoelpt ova copy of thin roam,placing <br /> the building pemdl ow Ter on notlCe of ihte eeeeeement end gto eondltlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />