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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> t� <br /> `} Date Permitted �2.3 <br /> Builder Name/Owner Name cD k Control#' . <br /> County Parcel Na. - �Z�" l '�-11d3z}-(��ZO SubDIv: <br /> Address/Location <br /> Classification/Type of Use 9(r nv l <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑No How Determined <br /> Impact Fee Amount $. 3, 3 00 Zone No. TAZ: <br /> s` <br /> SCHOOL IMPACT FEE <br /> Account (0561 Single-FamAy Detached House Amount $ �a 4 � <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 9 23) Collection Fee <br /> Exempt n Yes Q 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 $ 761 <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 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 /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply receipt ofa copy of this form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />