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PASCO COUNTY, FLORIDA <br /> Permit No. • t�® <br /> Date Permitted t— a — <br /> Builder Name/Owner Name :LOIA� Control#' <br /> County Parcel No, 2Z_2, (WO.Qg"12170 SubDIv: <br /> Address/Location ?.Ll. W►)n t - <br /> ClassfficationlType of Us@te <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes No How Determined <br /> Impact Fee Amount .$. i Zone.No. TAZ: <br /> SCHOOL`IMP.ACT'-FEE <br /> Account '(056) Single-Family Detached House Amount $ __ / f., 2—(S <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt a Yes- .C1 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 s ,769, S f— <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 Amount l _ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> r <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'OFFICE•OF PASCO COUNTY <br /> Acknowledgement below dose not Imply acceptance of concurrence,but simply recelpt of•a copy of this form,placing <br /> the building permit owner on notledL of this-assessment and thq conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />