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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted .Z�. <br /> Builder Name/Owner Name _ � }Y� Control#' ' <br /> County Parcel No, 3.�2,5-21- (11iDC�/�0/'70f0.0OU SubDiv: <br /> Address/Location <br /> ClassificationlType of Use L <br /> TRANSPORTATION IMPACT FEE _ Rate: Sq.Ft Unit: 2, 23� <br /> Exempt Yes No How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ _ �!• } <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt F1 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(09 6 <br /> Exempt ❑Yes ❑ No How Determined <br /> L113RARY,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 CENTRALPERMITTING OPFICE 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 some. <br /> f ' <br /> i DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />