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PASCO;COUNTY, FLORIDA <br /> Permit:No. (F Z <br /> Date Permitted _3 p= � <br /> Builder Name/owner Name "ti-a4— . L Control#' <br /> County Parcel No. Z/ 011 d b d b(O 6 SUbDIV: <br /> Address/Location <br /> ClassificatioprType of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit:21 OZ6 j <br /> Exempt [].Yes No How Determined <br /> Impact Fee Amount $.cad G 32 Zone No. TAZ: <br /> SCHOOL IMPACT-FEE- <br /> Account (056) Single-Family Detached House Amount $ _ <br /> (057) Mobile Home <br /> (058) Other.Residentlal <br /> 6.23) 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 $ ,74/wl v <br /> i 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 Amours - <br /> RESOURCE FEE ' ERU <br /> TOTAL AMOUNT <br /> Prepared By ' Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE•ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL-AMbUNTS LISTED HAVE <br /> BEEN.PAID 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 assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />