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PASCO COUNTY, FLORIDA <br /> _ Permit No. <br /> - Date Permitted 57-:44Z} <br /> Builder Name/Owner Name � �y�r► Control#' <br /> County Parcel No. 3t.-,Z"S 2_L I(n 6(�7ao- Il/d SubDiv: !4t <br /> Address/Location <br /> Classi8cationrrype of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount ,$ ���a' Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single Family Detached House Amount $ tq r jf <br /> (057) Mobile Home <br /> (056) Other Residential <br /> 123) Collection Fee <br /> Exempt []Yes 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 Account 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 /> or <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 /> Acknowiedgement-below does not imply acceptance of concurrence,but simply receipt ot•a.copy of this form,placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> f_ <br />