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PAS CO COUNTY, FLORIDA <br /> Fillr - <br /> It Date <br /> Date PaoNo nitted <br /> Builder Name/Owner Name Control#'� I v� • <br /> f County Paroel No. 01110.blh)-06 SubDiv: ` , <br /> Addressltocation <br /> i ClasslBcatlon/rype of Usq Siyt <br /> I <br /> Rate: Sq.Ft Unit <br /> TRANSPORTATION IMPACT FEE 2/ Z i <br /> l' Exempt ❑Yea ❑No How Determined ' <br /> f ; Impact Fee Amount S3 Zone No. TAZ- <br /> E SCHOOL IMPACT FEE ; <br /> Account (058) Sftle-Fa Tilly Detached House Amount $ 7 <br /> (: (057) Mobile Hc me <br /> (055) Other ft ildentlal <br /> 23) Wleollor Fee ; <br /> Exempt d Yes ❑No Now Determined <br /> IPARKS AND RECREATION FEE <br /> Land Account Land Credit land Total <br /> Recreation Account Recreation Credit Recreation Total / i <br /> Zone TOTAL AMOUNT - 76%ta•Sk y <br /> j <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land'Atxount Lend Credit Land Total j <br /> Faciilty.Acoount Facility Credit Fad*Total <br /> Exempt ❑Yes ❑No How Determined Total Amount _ I <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By " Checked By <br /> NO CERTIFICATE C F OCCUPANCY WILL 9E ISSUED OR FINAL INSPECTION <br /> PERFOM ED UNTIL THE TOTAL AM04NTS LISTED HAVE <br /> .BEEN PAIDAND <br /> RECEIPTED FOR I Y ACENTRAL PERMITTING OFFICEOF PASCO COUNTY <br /> I1cW�oiModaenuntbtlDwgooe tlmptyaeooytetwofeoncurtmco,butetrnplyreooiptotawplYorthlrrorm,D <br /> fhe bulldnp psmilt ow ter on noftee of this assoswam and ftu coMmtlom or payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />