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i <br /> � 1 <br /> y. <br /> PASCO COUNTY, FLORIDA <br /> 4 Permit No. <br /> ' - - Date Permitted - 7rd <br /> I 9 <br /> Builder Name/Owner Name t e- Control#' j <br /> County Parcel No. g_,q_25-2j_` &_ bj0DV p jS"n SubDiv: 170/vir4A <br /> t <br /> Address/Location J t° <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: I 'tP ' <br /> k <br /> G <br /> Exempt ❑jles ❑ No How Determined <br /> F ,. <br /> . impact Fee Amount $. Zone No. TAZ: <br /> t <br /> SCHOOLIMPACT'FEE <br /> Account (056) Single-Family Detached House Amount $ TLC <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 4 23) Collection Fee <br /> Exempt dyes No How Determined <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation <br /> nn7Tottaal <br /> Zone TOTAL AMOUNT $ !�1•`�E? <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/ p--l" <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By r 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 /> I <br />