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.PASCO COUNTY, FLORIDA <br /> Permit'No. <br /> Data Permitted 11 -7-4Za <br /> Builder Name/Owner Name 4e4 i ,--g�,�, Control#' " <br /> County Parcel No. 2-;- Z(z / 0//a 0= ljg& SubDiv: + <br /> Address/Location � <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft-Unit: <br /> Exempt fifes No How Determined <br /> Impact Fee Amount $.3"t 6 32.- Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> Account (058) Single-Family Detached House Amount $ <br /> (057) Mobile.Home <br /> (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 $7��` <br /> Exempt []Yes ❑No How Dete"rmined'& <br /> LIBRARYFEE <br /> Land-Atrcount 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 /> m: <br /> :., Prepared By .• __ Checked-By <br /> NO CERTIFICATE 00 OCCUPANCY:WILL.BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL.THE TOTAL AMOQNTS LISTED HAVE <br /> BEEN PAID AND- <br /> RECEIPTED FOM BY A CENTRAL PERMI hWdi OFFICE-OF PASCO.COUNTY <br /> ;rt Acknowledgement below does_not imply acceptance of concurrence,but simply receipt ota copy of thie fdmt.placing <br /> the building pemrlt owirer on notes of this assessmentand Die condidons of payment for same. <br /> DATE ; RECEIVED BY <br /> RECEIPT NO. DATE BY <br />