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I, # <br /> PASCO COUNTY, FLORIDA <br /> Permit No. 21 Z <br /> Date Permitted' —� <br /> Builder Name/Owner Name u 'x Control k <br /> County Parcel No. 2.-2�?�-0100-b i q 0-000 SubDiv: 5i� b <br /> Address/Location 0&5 6(0 tLT <br /> Classiflcationtlype of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit G� <br /> f Exempt ❑Ves ❑ No How Determined <br /> Impact Fee Amount $. �63�.cr�> Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ _-a <br /> (057) Mobile Home <br /> (058) 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 $ 761,Vt'k <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 <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 for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />