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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted Za <br /> Builder Name/Owner Name 2 Control <br /> County Parcei No. Miv: S <br /> Address/Location '5!i687- L _ CQ <br /> Classification/Type of Use (e_ ',�Ifn 1, <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2-1 3(5 <br /> Exempt []Yes R No How Determined <br /> A Zone No. TAZ: <br /> Impact Fee mount <br /> SCHOOL IMPACT FEE 12 <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> (123) Collection Fee <br /> Exempt n 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 <br /> Exempt D Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERLI <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 receipt of 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 />