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! is <br /> PASCO COUNTY, dFL®RIDA <br /> Permit No. <br /> - - Date Permitted <br /> 4 <br /> Builder Name/Owner Name kle&.4 ge [6 P$ Control#' <br /> County Parcel No. -2.b--2_%--p 1IP-006do.,,Z6OSuaDfv: <br /> r /� <br /> Address/Location 's l�'de Yrt�✓'l q <br /> Classification/Type of Use r /� �rty <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3,1 351 <br /> Exempt ❑Yes [] No How Determined <br /> E <br /> t Impact Fee Amount $. (�3� Zone No. TAZ: <br /> ' SCHOOL IMPACT FEE 60 <br /> f Account (056) Single-Family Detached House Amount $ 01 AC/ <br /> (057) Mobile Home <br /> (056) Other Residential <br /> t 123) Collection Fee <br /> I. Exempt �Yes ❑No How Determined <br /> f <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 0 No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By 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 PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence,but simply.recelpt of 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 />