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.PASCO-COUNTY, FLORIDA <br /> t _ _ Permit No. Cj <br /> Date Permitted --gib-l0'� <br /> ~Builder Name/Owner Name �Y�!"� Control#' . <br /> County Parcel No. ? `'2,�, 2-1 0 1 1 I (` L _. @ubDly: vi <br /> Address/Location q I Z 44r-nWn,, <br /> Classiflcationfrype of Usq jtp. 4 {(' <br /> TRANSPORTATION it111PACT FEE Rate: Sq.Ft Unit:,—,At, s <br /> Exempt Ves -Q No How Determined <br /> Impact Fee Amount $.3_4 32— Zone No. TAZ: <br /> k <br /> ` SCHOOL IMPACT-FEE <br /> Account (056) Single-Family Detached House Amount $ 4 1j, 28 <br /> (057.) Mobile Home <br /> (056) Other Residential <br /> 123) Collection Fee <br /> Exempt 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(0.:i f%-, <br /> Exempt ❑Yes y[j No How Determined <br /> LIBRARY FEE ~ <br /> Land Accounf 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 /> N( GERTIFICAT' 'OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PEROORMEC►UNTIL THE TOTAL:AMOUNTS LISTED HAVE <br /> BEEN'PAIV 0 <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Aoknowledgement below does.npt imply acceptance of concurrence,but simply receipt of-a copy of thle:form;,placing <br /> ttka building permit owner•"on notice of this assessment and.tha conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO, DATE BY <br />