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1 <br /> PASCO COUNTY, FLORIDA <br /> Permit No, 1 <br /> ( Date Permitted _ _= <br /> Builder Name/Owner Name �I.t.t Control#' " <br /> County Parcel No. _6 7 2_� zi (4 MID0 b bzC/l SubDiv: -cS <br /> Address/Location 2 �r S <br /> 3 <br /> Classlflcatlonrfype of Use ( lie / <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑1(es ❑ No How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ r 28 <br /> (057) Mobile Home <br /> (058) other Residential <br /> 23) Collection Fee <br /> �. Exempt d Yes ❑No How Determined <br /> t <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <( X <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 Amourti 5 <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 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 />