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PASCO COUNTY, FLORIDA <br /> Permit No: <br /> `'_ Date Permitted �_�� _ <br /> Builder Name/Owner Name c (1#G f Control#' <br /> County Parcel No. c —Z 5�- o1 7a^ t�- SubDiv: <br /> t f Address/Location &ock m <br /> Classlticationtrype of Usq t _ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2 3&L <br /> Exempt ❑ 'es ❑ No How Determined <br /> Impact Fee Amount b 3a+ Zone No. TAz: <br /> SCHOOL IMPACT FEE <br /> Account 058 Single-Family.Detached House Amount $ 1. 243 <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes 0 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 $ 76 9• S1 <br /> '+ Exempt ❑Yes ❑ No How Determined <br /> 4 LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> rarw:. tv fy . <br /> IN' <br /> r Exempt ❑Yes No How.Determined Total Amount <br /> RESOURCE FEE' ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> { PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> x,. RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> ks <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply recelpt ofa copy of thle form,placing <br /> the bullding permit owner,on notice of this assessment and the conditiona of payment for some. <br /> t: ' <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />