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PASCO COUNTY, FLORIDA <br /> Permit No. _ <br /> Date Permitted Zj.�— 7 7-D <br /> Builder Name/Owner Name Ut l Z C 11/0 49i Control#' <br /> County Parcel No. .�� : 2 l b b. t D SubDiv: <br /> Address/Location S E)r <br /> ClessiflcationtType of Use SIVA <br /> TRANSPORTATION IMPACT FEE Rate: 'Sq.Ft Unit:. c <br /> Exempt 0'Yes •Q No How Determined <br /> Impact Fee Amount — Zone No. TAZ: <br /> r <br /> SCHOOL'IMPACT'FEE <br /> Account (056) Single-Family Optachad House Amount <br /> (057) Mobile Home <br /> s (058) Other Residential <br /> 123) Collection_Fee <br /> Exempt [�Yes . Q 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 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 t Checked By <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'PERMCITING OFFICE.OF,PASCO COUNTY <br /> Acknowledgement below.dow not Imply acceptance of concurrence,but simply receipt ota:copy of this farm,placing <br /> tha•bOding permit ow60 on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />