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PASCO COUNTY, FLORIDA <br /> r <br /> Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name � Control#' <br /> County Pafcei No. 7-4f 2-4 2,1 61 Q0aW Z,ZO SubDiv: ! <br /> Address/Location L39 7 u' krwcme-k <br /> t Classiflcation/Type of Us@ <br /> �." . TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 41 <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $. 3/ 632- Zone No. TAZ: <br /> SCHOOL IMPACT FEE ! v' / <br /> Account (056) Single-Family Detached House: Amount $ 7 !� <br /> (057) Mobile Home <br /> (058) 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 /> Zone TOTAL AMOUNT s,7U1 <br /> Exempt ❑Yes ❑No How Determined <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 al Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> Of.N: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 conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />