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' l <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted - �r <br /> Builder Name/Owner Name _�� �►� Control#' l <br /> County Parcel No. -4-21— D T) JJ"_D SubDIv: KA <br /> AddresslLocation (3D61 <br /> Classificationfrype of Use <br /> TRANSPORTATION IMPACT FEE . Rate: Sq"Ft Unit: _ <br /> Exempt- ❑Yes ❑ No How Determined <br /> impact Fee Amount $., --- Zone No. TAM <br /> SCHOOL IMPACT FEE Account '(056) Single-Family Detached House Amount $ tq <br /> (057) Mobile Home <br /> (058) Other Residential <br /> S 123) Collection Fee <br /> Exerhpt ( 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 $ 762LA <br /> Exempt ❑Yes ❑ No How Determined <br /> 1 � 36,( <br /> LIBRARY FEE 3 I f <br /> Land Accounf 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 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 receipt 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 />