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f � <br /> PASCO COUNTY, FLORI®A <br /> bM9t No. ZZ J z <br /> Date Petmltted 1=7 0 <br /> i Builder Name/Owner Name l!n f�.r ITo)vl s Control W _ ` <br /> t County Patcel No. . f- -(�-ZI�t7110- o SubDly: ► � ''` <br /> Address/Location t 3 ` �v— <br /> ClasslflcatlonlType of Usq cS/ <br /> I <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2—/_,0� <br /> 4, Exempt ❑Yes ❑No How Determined <br /> `l Zone No. TAZ: <br /> ` Impact Fee Amount S. �i�DJ�� I <br /> . SCHOOL IMPACT FEE <br /> I Account (0561 Single-Family Detached House Amount <br /> (057) Mobile Home <br /> (05fs) Other Residential <br /> 123) Collection Fee , <br /> Exempt Yes ❑No How Determined <br /> ' PARKS AND RECREATION FEE <br /> Land Account __ Land Credit Land Total <br /> ' Recreation Account Recreation Credit -Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> sd <br /> Exempt 0 Yes D No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total j <br /> Facllity.Acoount Facility Credit Faciilty Total <br /> Exempt ❑Yes ❑No Now Determined Total Amoun <br /> RESOURCE FEE , ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE.OF OCCUPANCY WILL BE.IS$UED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> . BEEN PAID AND ' <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does notiMply acceptance of Concurrence,but simply receipt of a copy of this form,placing <br /> the buUding permit owner on notice of We assessment and the condUIons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />