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PASCO COUNTY, FLORIDA <br /> Permit No. To. <br /> Date Permitted '7-2,7 4> <br /> Builder Name/Owner Name C 4 � Y Control#' <br /> County Parcel No. �Z S?. 2cx2-c�[ SubDiv: 7,ebt-LI" t <br /> Address/Location te6Lf 7_T'_ <br /> r <br /> Classificationtiype of Use <br /> z TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑yes ❑ No How Determined <br /> Impact Fee Amount $ r 6 3?i Zone No. TAM <br /> SCHOOL IMPACT FEE <br /> i Account (056) Single-Family Detached House Amount $ �. l�t 2� <br /> (057) Mobile Home T <br /> fi (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 $ 26 Ue <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 ❑ 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 /> Acknowiedgement.below does not Imply acceptance of concurrence,but simply,receipt of•a copy of this form,placing the building permit owner.on notice of this assessment and tha conditions of Payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />