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s <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Zz <br /> Date Permitted — 2� <br /> �Buiider Name/Owner Name < i J +\ Control#' <br /> County Parcel NoJ2-7..-�2_G- 0 lCQ- SubDiv: & t <br /> Address/Location 3S51 6 G{ <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> I ! <br /> Impact Fee Amount �. l b,� Zone No. TAZ: <br /> SCHOOL IMPACT FEE �// <br /> i Account (056) Single-Family Detached House Amount $ �?t- , <br /> 2-8 <br /> (057) Mobile Home <br /> 4 (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 $ �. <br /> Exempt ❑Yes ❑ No How Determined'4 <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 dam?_ _ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t 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 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 />