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PASCO COUNTY FLORIDA <br /> Permit No. <br /> Date Permitted' <br /> �. <br /> t� ,Builder Name/Owner Name Control# <br /> . County Parcel No. SubDiv: <br /> Address/Location &3Z k - <br /> Classiflcationfrype of Use e <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt []Yes ❑ No How Determined <br /> e <br /> impact Fee Amount $. 3c�3 Zone No. TAM <br /> t <br /> E SCHOOL IMPACT FEE / <br /> i Account (056) Single-Family Detached House Amount <br /> (051) Mobile Home <br /> (058) Other Residential <br /> t 23) Collection Fee <br /> x Exempt 6 Yes ❑No How Determined <br /> PARKS ANDXRECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ (v.�J: <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 F1 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 receipt of•a copy of this.form,placing <br /> the building permit owner.on notice of this assessment and the conditlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />