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PAS 0 COUNTY, FLORIDA <br /> • •Pilf�rdtNo. .z2:Z8/ <br /> Date Paimitte <br /> Builder Name/Owner Name Y Control#' _ <br /> l County Pafcel No. 1 6 S bDiv: <br /> f AddresslLocadon Q L <br /> j' ClassiflcadoM'ype of Us@ r51 <br /> ` TRANSPORTATION IMPACI FEE Rate: Sq.Ft Unit: Zr Z3 <br /> Exempt ❑Yes ❑No How Determined <br /> i <br /> Impact Fee Amount 3 0)) Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (o6B) Single-F mily Detached House Amount $ <br /> (067) Mobile H me <br /> (066) Other R sldendal <br /> i 23) Collecdo i Fee <br /> Exempt b Yes ❑No How Detemdned <br /> PARKS AND.RECREATION FEE i <br /> Land Account Land Credit Land Total it <br /> s <br /> Recreation Account Recreation Credit :Recreadon Tote) <br /> Zone TOTAL AMOUNT $ 76q-Sh ' <br /> • I <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Faci ily.Acoount Facility Credit Facility Total <br /> Exempt ❑Yes ❑NO How Determined Total Amount I <br /> RESOURCE FEE , ERU <br /> TOTALAMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE F OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFOR AED UNTILTHE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAIDAND . <br /> RECEIPTED FOR 1Y ACENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> AoknowiadgomwU baloW does 't Imply&wept=of commirencd,but dimply woelptofa copy of thb form,placing <br /> the Wkft pmnit ov=r on MU6 of tMe aedesament and tlul consom of payment for tame. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />