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FIASCO COUNTY, FLORIDA <br /> Permit No. j2 <br /> / Date Permitted �2?d,�o <br /> Builder Name/Owner Name 1 f/l b -' 1 8$ Control#' <br /> County Parcel No. ��r(-�� 0 jjo, r)DQ6- Aa SubDiv: <br /> Address/Location <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Ves ❑ No How Determined <br /> Impact Fee Amount $. (.3a, Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (068) 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 $ 9 5% <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 G ` <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t Checked-BY <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUER OR FINAL INSPECTION <br /> PERFORMEb UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,butsimpiy receipt of a copy.of this form,placing <br /> the building permit owner on notice of this essessment and the condltlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />