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t <br /> PASCO COUNTY, FLORIDA <br /> Permlt No. cJ� <br /> Date Permitted . <br /> Builder Name/Owner Name K �� Control#• <br /> • p <br /> County Parcel No, SubDiv: 176we& Ame'r— <br /> ¢ Addresstl.ocation <br /> _ Classiffcation/Type of Usq l� <br /> I TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No / How Determined <br /> Impact Fee Amount $- (0 . Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> i Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (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, <br /> LIBRARY FEE <br /> Land Accounf 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 r Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR-FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AM04NTS.LISTED HAVE <br /> BEEWPAID 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 owneaon notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />