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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name r .W71 Control#' <br /> County Parcel No. - 2�=2/ D/Qd((-D!goo-o/la 0 SubDiv: rF t U t? <br /> Address/Location 35 :5 (QA:g—_NW <br /> Classification/Type of Usetti 11�f <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: Z, 3(2- <br /> Exempt ❑Yes n No How Determined <br /> Impact Fee Amount $. 3,(p): 6Z Zone No. TAZ: <br /> SCHOOLIMPACTFEE <br /> Account (056) Single-Family Detached House Amount $ 26 <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes ❑No How Determined <br /> I <br /> PARKS.-AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <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 Amount4g._9�_�_ <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 AMO' UNT&LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PEFtMt1TING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply receipt of a 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 />