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PASCO COUNTY, FLORIDA <br /> Permit No. 2 <br /> Date Permitted <br /> ~Builder Name/Owner Name Control#' <br /> County Parcel No. ' p 2-Zk 2, 6 3eo 60cA6 � SubDiv: �T <br /> Address/Location �_ <br /> Classlflcatlon/Type of Us@ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt- ❑Yes [] No How Determined <br /> impact Fee Amount $. Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ ¢��J <br /> (057) Mobile Home <br /> (056) Other Residential <br /> 123) Collection Fee <br /> r Exempt [�Yes [Q No How Determined <br /> i. <br /> . PARKS AND RECREATION FEE, <br /> Land Account Land Credit Land Total <br /> p Recreation Account, Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ » ► K 3, 06 <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 Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t �-= T Checked By <br /> NO CERTIFICATE OF OCCUPANCY W. ILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEMPAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence,but simply receipt ofa copy of thls 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 />