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` PASCO COUNTY, FLORIDA <br /> Permit No. [Q�o <br /> nn Date Permitted <br /> Builder Name/Owner Name K Control W <br /> —fl= B— <br /> County Parcel No. L-)/D D D l 8dn subDiv: cS 1 <br /> Address/Location <br /> Classiflcatlonlrype of Us@ 61 <br /> , <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2204oz-, <br /> Exempt Yes 0-No How Determined <br /> Impact Fee Amount $,.31 b 32- Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (058) Single-Family Detached House Amount <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes• .Q No How Determined <br /> PARKS,AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreatiop Account Recreation Credit -Recreation Total <br /> Zone TOTAL AMOUNT $. ,7 <br /> i Exempt ❑Yes [] No How Determined <br /> f <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 CERTIFJCATE OF OCCUPANCY WILL BE ISSUED OR.FINAL INSPECTION <br /> PERFORMED UNTIL.THE TOTAL AMOUNTS'LISTED HAVE <br /> BEEWPAID 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 this form,placing <br /> the building"permit owner on notice of this Assesement'and the conditions of payment for same. <br /> DATE RECEIVED-BY <br /> RECEIPT NO. DATE BY <br />