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PASCO COUNTY, FLORIDA <br /> Permit No. ' <br /> Date Permitted 1^�Zc� <br /> -Builder NamelOwner Name ,b ) t" Control <br /> County Parcel No. - -subDiv: 60,&i <br /> Address/Locatlon -777 9 4- 1c u <br /> 4 � <br /> Classification/Type of Usip <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: _ <br /> ' Exempt Q Yes Q No How Determined -art <br /> Impact Fee Amount $.' 61'G 32, Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Aetached House Amount $ <br /> (057) Mobile Home <br /> I (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 A <br /> LIBRARY FEE <br /> Land Account Land Credkt Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑ Yes ❑ No How Determined Total Arnount � <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 13Y 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 buliding permit owner.on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />