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PASCO COUNTY,-FLORIDA <br /> Permit No. _ <br /> Date Permitted ; = �L <br /> Builder Name/Owner Name Control#' ' <br /> County Parcel No. OCVI�b/6/&bDiv: `U{lie <br /> '1 <br /> Address/Location �- <br /> r <br /> Classificatlon/Type of Uso C�3T <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes n- No. How Determined <br /> Impact Fee Amount $_&,. 3 i Zone No. TAZ: <br /> SCHOOL IMPACT-FLEE <br /> Account (056) Single-Famlly Detached House Amount $ <br /> (057) Moblte Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt d 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 $ . ' <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 n No How Determined Total Amount ~ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By a Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL 6E,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 doss 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 same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />