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h PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted <br /> -Bui der Name/Owner Name �t/tf�' 42 - Control <br /> County Parcel No. Z CfG24 2/6110 dQQ,�,C) ` SubDiv: <br /> Address/Location 3! <br /> r <br /> ClassificationlType of Us@ <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 $ _ � <br /> (057) Mobile Home <br /> (056) Other Residential <br /> 23) Collection Fee <br /> Exempt d Yes ❑No How Determined <br /> 1. PARKS AND RECREATION FEE• <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> i Zone TOTAL AMOUNT $ X�SW <br /> L. Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Accounf Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amounts- ' <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 /> BEER,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 form,placing <br /> the building permit owner.on notice of this assessment and the conditlons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />