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k , <br /> J PASC0 BOUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name c Control t <br /> County Parcel No. S:�;.7N5=21-Q/ SubDiv: r <br /> Address/Location S <br /> Classlfication/Type of Use <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: <br /> Exempt ❑'1'es ❑ No jj How Determined <br /> i. <br /> Impact Fee Amount $. t br r Zone No. TAM <br /> 1 SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ { if <br /> (057) Mobile-Home <br /> (058) Other'Residentlai <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` 7 <br /> Zone TOTAL AMOUNT $. L ' <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 Atnount,._O _ <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE.OF OCCUPANCY.INILL BE ISSUED OR"FINALMSPECTION <br /> PERFORMED CINTIL THE TOTAL/MOPN°fS LISTED HAVE <br /> BEWPAIDAND <br /> RECEIPTED FOR BY ACENTRAL PERMITTING OFFICSOF PASCO COUNTY <br /> AcknoWedgement Wtow,doea not Unpty acceptance.of concurrence,but stmpiy mceipt of-a oopjrofttde form,placing - <br /> the building permit owner.on nodes of thle`assesement and thr oondlgoa s of paymwtfor same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />