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CIA COUNTY, FLORIDA <br /> Permit No, Z �� <br /> Date Permitted 7-�-zb?�Z <br /> ^Builder Name/Owner Name mer Control#' " <br /> County Parcel No. 35 ZS-Z1- 0(4c"o i O'SubDiv: <br /> Address/Location `5 0 bt- <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2_r ,%7 <br /> Exempt n ves ❑ No How Determined <br /> Impact Fee Amount $. �J(�3 2s Zone No. TAZ: <br /> r <br /> l SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> i (057) Mobile Home <br /> (056) 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 $ -7Q S,�S <br /> Exempt Yes [Q 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 Amoun&,: / <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 foraame. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />