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F, <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name Control#' <br /> County Parcel No. SubDiv: Sr <br /> Address/Location <br /> Classfflcadon/Type of Us@ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit 2/ <br /> Exempt ❑Yes Ej No How Determined <br /> yy Impact Fee Amount s, to 3 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (068) Other Residential <br /> 23) Collection Fee <br /> Exempt Yes ..F1 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 E]Yes [] No How Datermined.4 <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt E]Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERLI <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> v <br /> NO CERTIFICATE OF OCCUPANCY.WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THETOTAL 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 Facelp:i of-4 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 P <br /> RECEIPT NO, DATE BY <br />