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PASCO COUNTY FLORIDA <br /> Permit No. 2-4r <br /> 1 _ _ Date Permitted 7r <br /> Builder Name/Owner NameT Control# j <br /> County Parcel No. V Z641 ©f 0,9- ,0 �0 -gdyS' ubDiv: J5; <br /> Address/Location <br /> Classification/Type of Use 36 Ito <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt n Yes ❑ No How Determined <br /> Impact Fee Amount $. 2 Zone No. TAZ: <br /> it <br /> SCHOOL'IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ��/4- Z <br /> (057) Mobile Home <br /> 4 (056) Other Residential <br /> i 23) Collection Fee <br /> Exempt 6 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 $ <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total J <br /> Exempt ❑Yes ❑ No How Determined Total Amount / <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By I 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 />