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PASCO COUNTY, LORI®A <br /> k <br /> " Permlt No. <br /> Date Permitted �t. 6,0A� <br /> i Builder Name/Owner Name )i 1"r ' Control#" <br /> I � <br /> } County Parcel No. �(0.2 .2�-�J-t11•(7�2at?�(��?2 SubDiv: "7Y <br /> w , <br /> Address/Location�. Classification/Type of Use A` (e rt <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 246(1-- <br /> . Exempt Q Yes Q No How determined <br /> Impact Fee Amount $. (ate, t Zone No. TAZ: <br /> SCHOOL IMPACT FEE �/ r <br /> Account (056) Single-Family Detached"House Amount $ f/ 3 <br /> (057) Mobile Home <br /> I (058) Other Residential <br /> i 123) Collection Fee <br /> I Exempt �Yes Q 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 /> ,i <br /> Exempt Q Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> k Facility Account Facility Credit Facility Total <br /> Exempt [] Yes Q No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By J Checked By <br /> 0 <br /> NO CERTIFICATE OF_OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE;TOTAL.AMOUNTS USTED 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 simpty,racelpt 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 />