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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted ,--�7-2e <br /> Builder Name/Owner Name S)4 Control# <br /> County Parcel No. (3 "25— )-od Div: <br /> Address/Location 3,56 U 6 k - <br /> ClassiflcatioM'ype of Usk <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 3 t/43 <br /> Exempt Q Yes Q No ff How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Famliy Detached House Amount $ , 211/1 Z8 <br /> (057) Mobile Home <br /> (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 $7I <br /> Exempt ❑Yes ©No How Determined 4 <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 ERU <br /> TOTAL AMOUNT <br /> Prepared By Z _ Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED.0R FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AM04MTS LISTED HAVE, <br /> BEEN,PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFIC60F PASCO COUNTY' <br /> Acknowledgement below doea not Imply acceptance of concurrence,but simply receipt ofa copy of this form,placing <br /> the building permit owner on notice of thle assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />