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1PAS+CO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name !� f!U llA 4A2 Control# _ <br /> County Parcel No. (� ���;Z -�(1?--�i -f✓3�110(�-f7� l4 Su6piv: <br /> Address/Location ttL A YJ LAII <br /> ClassificationtType of Use l <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3� <br /> Exempt ❑Yes Fj No How Determined <br /> Impact Fee Amount $. 316;3 a+dp Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (0561 Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt [S]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 $ <br /> Exempt [ Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes 0 No How Determined Total Amour <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 /> �t <br />