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f � <br /> PASCO COUNTY, FLORIDA <br /> r <br /> . Permit No. <br /> � Date Permitted -� <br /> �Z <br /> Builder Name/Owner Name } 7�Tb�i� i'ti Control#' <br /> County Parcel No, oft o Z0,b �bDiv: <br /> Address/Location qDJ— <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE ate: Sq.Ft Unit: <br /> Exempt F1 Yes No How Determined <br /> impact Fee Amount zone No. TAZ: <br /> SCHOOL IMPACT FEE. r <br /> Account (056) Single-Family Detached House Amount $ , (/ <br /> (057) Mobile Home <br /> (050) Other Residential <br /> 23) Collection Fee <br /> Exempt d 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 $ 7&/p <br /> 6�6 <br /> Exempt Yes No How Determined <br /> I 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 ERLI <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE:OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL T,HE TOTAL AMOUNTS LISTED HAVIt <br /> BEEN PAID AND <br /> RECEIPTED FOR 13Y A CENTRAL.PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement balow does notimply 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 />