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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name Control W . <br /> County Parcel No. '2 ubDiv: <br /> Address/Location <br /> c <br /> Classification/Type of Use F <br /> TRANSPORTATION IMPACT FEE Rate Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount Zone No, TAZ: <br /> SCHOOL IMPACT FEET r <br /> Account (056). Single-Family Detached•House Amount $ <br /> (057) Mobiie,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 Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ too <br /> Exempt ❑Yes No How Determined-Q <br /> f <br /> LIBRARY-FEE <br /> Land Account Land Credit Land Total. <br /> Facility Account Facility Credit Facility Total j <br /> Exempt ❑Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> v 0- <br /> NO CERTIFICATE OF OCCUPANCY WILL BE.ISSUED,OR-FINALJNSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement below-doea not Imply acceptance of concurrence,but simply recelpt 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 />