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f t <br /> PASCO COUNTY, FLORIDA <br /> z <br /> Permit No. `S <br /> Date Permitted <br /> ^Builder Name/OwnerName Control#' " <br /> County Parcel No, 03-26 2_1-b130-6QQ Q-de b SubDiv: r- <br /> Address/Location h 6 'a 1 <br /> Classitication/Typa of Use i z? oil, <br /> �Q <br /> TRANSPORTATION IMPACT FEE Rate, Sq.Ft Unit: _ <br /> Exempt n Yes Q No How Determined <br /> Impact Fee Amount Zone No: TAZ: <br /> y <br /> i SCHOOL IMPACT'FEE " <br /> Account (056)' Single-Family petached 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 Ladd Total <br /> Recreation Account Recreation Credit Recreation'Total <br /> Zone TOTAL AMOUNT $ <br /> Exempt ❑Yes n'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 Amoun <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By j Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL T E TOTAL AMOUATS DUSTED 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 recelpt of-4 copy of We form,placing the bullding permit owner on notice of this assessment and the conditions of"payment for same. <br /> DATE 'RECEIVED BY <br /> RECEIPT NO. DATE BY <br />