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r <br /> PASCO COUNTY, FLORIDA <br /> Permit-No. � 3 <br /> ``�I �/ Date Permitted _Z <br /> t6 <br /> Builder Name/Owner Name 11 fZ r Control W '. <br /> County Parcel No. [ o—DO I00-DO q O SubDiv: <br /> E Address/Location q503 Z tokk Sh�c Q)1 z <br /> Classiticatlon/Type of Use <br /> P <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: _ <br /> Exempt ❑Vee ❑ No How Determined <br /> 4Y Impact Fee Amount $•3r 'Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> ' Account (056) Single-Family petached House Amount $ <br /> h (057) Mobile Home <br /> (058) Other Residential <br /> f 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 $ 7 61-56 <br /> ,- Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amoun <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 /> b> BEEN PAID AND <br /> RECEIPTED'FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply receipt of•a.copy of thla form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment-for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />