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! <br /> t PASCO COUNTY, FLORIDA <br /> _ Permit No. �f <br /> Date Permitted C,.-:& <br /> aBuilder Name/Owner Name Control#' <br /> County Parcel No. 2#-Z4-Z 1-13//O,f_ lb-� SubDiv: <br /> EAddress/Locatlon Ca/ f <br /> Classification/Type of Use t� <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2,,60 <br /> Exempt ❑Yes [] No //How Determined <br /> Impact Fee Amount $. i l4J?�i Zone No. TAZ: <br /> e <br /> SCHOOL IMPACT FEE / <br /> i Account (056) Single-Family Detached House Amount <br /> (057) Mobile Home <br /> i (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [�Yes . Q 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 $ y <br /> Exempt ❑Yes ❑No How Determined <br /> L113RARY 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 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 same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />