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PASCO COUNTY, FLORIDA <br /> ' Permit No. <br /> /p Date Permitted — -ZRV- <br /> Builder Name/Owner Name Pxl-k 1! me_ 65)2�t/ Control#' <br /> County Parcel No. SubDiv: Oats I AW <br /> Address/Location & !-� <br /> Classiflbationtrype of Usg <br /> U <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No Flow Determined <br /> Impact Fee Amount $. Zone No. TAZ: <br /> SCHOOL IMPACT'FEE �G7 <br /> Account (056) Single�Famlly Detached House Amount $ : 7 U <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 Credlt Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount _ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By i 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 conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />