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PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name �� T � Control#` <br /> County Parcel No. 3 Z/ �" /. 0,-)000) Wo SubDiv: <br /> Address/Location <br /> rJ— <br /> Classification/Type of Use � t <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: �® /00. <br /> Exempt ❑ Yes ❑ No How Determined <br /> Impact Fee Amount $. k2 <br /> � Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $- <br /> (057) Mobile Home <br /> (058) Other Residential <br /> dYes <br /> 23) Collection Fee <br /> Exempt ❑ No How Determined <br /> E ' <br /> . PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> 576 '7Z <br /> Y Exempt ❑ Yes ❑ 'No How Determined <br /> �i <br /> -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 �Ul ftz'_ - Checked By <br /> NO CERTIFICATE-OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <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 does not imply acceptance of concurrence,but simply receipt of•a copy of this farm,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 />