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I <br /> 1 <br /> PASCO COUNTY, FLORI®A <br /> DatePWnitted /—Z/—Zo <br /> i . <br /> Suit der NamelOwnor Name b A Nl A,— Control#' • _ <br /> E <br /> CountyPargelNo. SubDiv: <br /> AddressrLocatlon �3 13 ,\, A,01 <br /> fv <br /> ClasalficatlorMpe of Usq & l <br /> TRANSPORTATION IMPACT FEE Rate: sq.Ft Unit 2-, 37.Z <br /> Exempt ❑Yes ❑No How Determined <br /> j Impact Fee Amount Zone No. TAZ: <br /> ; <br /> SCHOOL'IMPACTFEE <br /> Account (0501 Sbtgle•FamUy Detached House Amount S _ <br /> (057) Mom Home <br /> (068) Other ResldenUal <br /> i 23) Coltection Fee <br /> Exempt d Yes ❑No How Determined <br /> PARKS AND RECREATION FEE i <br /> Land Account Land Credit Land Total <br /> Recr®allon Account Recreation Credit •RacreaUonTotai <br /> Zone TOTALAMOUNT $ <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Lend Account Land Credit Land Total i <br /> FacMty.Axount Facility Credit FaoWty Total <br /> Exempt ❑Yes [:]No How DetemMed Total Amount i <br /> RESOURCE'FEE , ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIPICATE.OF OCCUPANCY WILL 8E.I5$UED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND ' <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICSOF PASCO COUNTY <br /> Achnordadpomant bWow does not MV]y nowpUm of cW cf tNa rum,pladny <br /> rhebulldirtp pamttownaron Wei of M araeument and ttut oandwanaarpaymantfor ume: <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> l.• <br />