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PASCO COUNTY, FLORIDA <br /> FibVt No. <br /> Date Petmitled <br /> l.E/L{1�r C` es' #' <br /> • ' Builder NemelOwner Name Control 7 <br /> t den� [� <br /> j County Parcel No. - -{ ld- ubDiv: ! <br /> Address/Locatlon <br /> ClassiticatlonRype of Usq �f �� r►1i i <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑No How Determined <br /> Impact Fee Amount $ -3/p3 Zone No. TAZ: <br /> SCHOOLIMPACTFEE l <br /> Account (05e) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> j (058) .Other Residential <br /> 23) Collection Fee <br /> Exempt d Yes ❑No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Lend Total <br /> Recreation Account Recreation Credit •Recreafllon/Total <br /> 7d <br /> Zone TOTAL AMOUNT $ / L56 <br /> • I <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account . Lend Credit Land Total j <br /> Fadllty.Acodunt Facility Credit Facility Total <br /> Exempt ❑Yes ❑No How Determined Total Amounv-� <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT <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 OFFICEOF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance or concurrence,but elmply recelpt ale copy of this form,placing <br /> the bull ft pump owner on notice of M assesainent and the condWom or psymud for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />