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r <br /> PASCO COUNTY, FLORIDA <br /> Permit No, <br /> Date Permitted (D _ <br /> Builder Name/Owner Name Leot.n T Control#• <br /> County Parcel No. Zs', &Z,, o((n.t54C+OD t 5Z b SubDly: �1'.d CA. &e, <br /> Address/Locatlon M 2 L 4 t+GV`rKtrn � <br /> Classification/Type of Us@tJtr <br /> i TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: 2 52 <br /> Exempt []1(es {Q No How Determined <br /> Impact Fee Amount $.3((P 32 Zone No. TAZ: <br /> E . <br /> SCHOOL IMPACT'FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (051) 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 s ,.](oa- (cam <br /> Exempt [1 Yes []No How Deteltt lheid.0 <br /> LIBRARY FEE <br /> ` Land Accouni 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 Checked By <br /> NO CERTIFICATEW OCCUPANCY:.WILL BE ISSUEQ.OR FINAL,INSPECTION <br /> PERFORME[3•WTIL-THE TOTAL.AMOUNTS LISTED HAVE <br /> • BEEN:PA)D . <br /> RECEIPTED FOR BY A CENTRAL PERIM- 17TAND <br /> ING OFFICE.OF PASCO COUNTY <br /> AcknoWedgemant below,doea not imply.acceptance of concurrence;but simply receipt of-4 copy of this form,placing <br /> the bultd(ng permit owner on notice of this assessment and the cbnditions of payment fo'r Satire. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> s, <br />