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PASCO COUNTY, FLORIDA <br /> I Permit No. <br /> Date Permitted 0— r <br /> 'Builder Name/Owner Name G" Control W <br /> County Parcel No. bb r- —0 ,?. ubDiv: <br /> Address/Location <br /> ClassiflcatioNType of Usq <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: , <br /> Exempt n fifes -(] No How Determined <br /> Impact Fee Amount . 1 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> (( Account (656) Single-Family Detached House Amount $ _12,L 2A?_ <br /> (057) Mobl(e Home <br /> (058) Other.Residential <br /> 23) Collection fee <br /> Exempt M Yes . Q No How Determined <br /> PARKS AWRECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7449, r' <br /> Exempt 0 Yes ��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 G Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> SEEN PAID AND <br /> RECEIPTED FOR 8Y A CENTRAI PEAMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below do not imply acceptance of concurrence,but simply receipt of a copy of this form,placing the bullding permit owner-on notice of hits assessment and the oondlttons of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />