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PASCO COUNTY, FLORIDA <br /> Permit No. c <br /> Date Permitted <br /> Builder Name/Owner Name fit <br /> ontrol#' " ,, <br /> County Parcel No. 3 DubDIv: �dj sq <br /> Address/Locatlon <br /> l Classiflcatlon(fype of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: z <br /> I � <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 $ 3, �.L�. <br /> (057) Mobile Home <br /> (056) 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 /> E i Zone TOTAL AMOUNT $ �Q��c� <br /> Exempt ❑Yes ❑ No How Determined <br /> L113RARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount <br /> i RESOURCE FEE' ERU <br /> TOTAL AMOUNT <br /> Prepared By -L �"� Checked By <br /> NO CERTIFICATE OF OCCUPANCY%MLL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> PEORPAID AND, <br /> RECEIPTED FOR.13Y A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence,but simply receipt of a copy of this form,placing the building pehnit owner on notice of this assessment and the conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO, DATE BY <br />