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PASCO CGUNTYj FLORIDA <br /> Permit No. <br /> Date Permitted Zp�—6 <br /> Builder NamelOwner Name ;_ �e.. Control#' <br /> County Parcel No. O.Z/,7—/, 2/ /Zd" � SubDIv: --)x1� A e3 <br /> Address/Location cllgg <br /> Classification/Type of Us@ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: .2, � <br /> Exempt' []Yes -[] No How Determined <br /> Impact Fee Amount , _ Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount <br /> (057) Mobile,Home <br /> (058) Other Residential <br /> 23) Collectlon Fee <br /> ` Exempt dyes . Q No How Determined <br /> PARKS AND RECREATION FEE- <br /> Lind Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT <br /> Exempt ❑Yes 4❑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 Amour <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t. Checked By <br /> i <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 /> I <br /> Ackm Wedgement below does not imply acceptance of concurrence,but simply recelpt of a copy of this form,placing <br /> the building permit owner.on nonce of this assessment and the conditions of payment for same. <br /> DATE <br /> RECEIVED BY � <br /> RECEIPT NO. DATE BY <br />