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t <br /> PASCO COUNTY, FLORIDA <br /> Permit No. <br /> fi Date Permitted _614 A <br /> Builder Name/Owner Name f,�►ut Control#' " <br /> County Parcel No. 61L%-jWZ) SubDiv: V <br /> Address/Locadon <br /> GlasslflcationfType of Usq Ile , <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: G '^ <br /> Exempt ❑Yes [] No How Determined <br /> Impact Fee Amount $. / Ob Zone No. TAZ: <br /> 1 <br /> SCHOOL IMPACT FEE � �jf/ A AL <br /> Account (055) Single-Family Detached House Amount $ <br /> i (057) Mobile Home <br /> i (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 /> Zone TOTAL AMOUNT $ 7W <br /> Exempt Q Yes ❑No How Determined:*'p <br /> • <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> I <br /> I 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 ISSUE. D.-OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOtiNTS 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 periiit owner on notice of this assessment and the condltidns of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />