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`. PASCO COUNTY, FLORIDA <br /> Permit No. , <br /> f Date Permitted <br /> Builder Name/Owner Name i��/� JLLF1 f`� ��'' Control#' . <br /> County Parcel No. (`�T �_t7k O--OW,675f) SubDiv: 14�t -S <br /> Address/Location hn <br /> Classification/Type of Use le <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2r <br /> Exempt ❑Yes [] No How Determined <br /> Impact Fee Amount $. • Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (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 /> z <br /> Zone TOTAL AMOUNT $ 20, 6;6 <br /> Exempt Q Yes 0 No How Determined S <br /> LIBRARY FEE <br /> } Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt (3 Yes Q No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By ` Checked By <br /> NO CERTIF.ICAT OF OCCUPANCY WILL BE ISSUED.OR FINAL:INSPECTION <br /> PERFORMED UNTIL THE TOTAL,AMOUNTS" LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTEDiFOR BY A CENTRAL PERMITTINO 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 />