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j <br /> r <br /> I <br /> PASCO COUNTY, FLORIDA <br /> Date <br /> D Petmllted <br /> Builder Name/Owner Nama �/l��r` Control 0' <br /> I <br /> t County Perot No. z — Z� �- a SubDIV: <br /> AddresslLocatlon <br /> ClaselNcatlon/rype of Usq i <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit � — <br /> Exempt ❑Yes ❑No How Determined <br /> Impact Fea Amount $3i 6 �• Zone No. TAZ: j <br /> � I <br /> SCHOOLUNPACTFEE <br /> Account (058) Single-Family Detached House Amount S f 0/4 Ztg <br /> r: (057) Mobile Home <br /> (055) Other Residential <br /> 128) Collectlon Fee A, <br /> f I Exempt Yes Q No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> ! Recreation Account Recreation Credit :Recreation Total i <br /> Zone TOTAL AMOUNT <br /> j <br /> Exempt 0 Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total i <br /> Faclllty.Acccunt Facility Credit Faculty Total <br /> Exempt ❑Yes ❑No How Determined Total Amount i <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT <br /> Prepared By f c/ Chaoked By <br /> NO CERTIFICATE OF OCCUPANCY.WILL DE•18SUED ORFINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND • <br /> RECEIPTED FOR BY A CENTRAL PERMI MNO OFFICE OF PASCO COUNTY <br /> aotuwwudpamtnt eelaw does not Impyr aoaoptenee of wncuryence,but elmpry re 1pt cfa oopy aim form,ptaaln➢ <br /> th®DuUdinp pump owntron retloo 01 Uda aeaeaemonl and eta renditions of paytnentfor tame. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />