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1 PASCO COUNTY, FLORIDA <br /> _ Permit No. lqaM <br /> Date Permitted <br /> RBuiider Name/Owner Name Yq,' j t6ne Control#' <br /> County Parcel No. 24 Z-1 0tr2,0 SubDiv: aS ^� <br /> Address/Location <br /> Classiflcation/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount __ Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single Family Detached House Amount $ 1 �, <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt dyes ❑No How Determined <br /> I <br /> i. PARKS AND RECREATION FEE, <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> Exempt ❑Yes ❑No How Determined. <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total s <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount*—J�r-- <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By 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 recelpt of a copy of this form,placing <br /> the building permit owner,on notice of this assessment and the conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />