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11, <br /> +t <br /> Y FIASCO COUNTY, FLORIDA <br /> _ Permit No. i l <br /> (} Date Permitted <br /> Builder Name/Owner Name Control#• ' � _ <br /> fi. County Parcel No. z-2 2- 06`�o aj3oD0/PubODiv: Si ltxradU <br /> Address/Location <br /> +at2 <br /> Classification/Type of Use _<ygt{. �_ <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: �f " <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $,- 2,0� `db Zane No. TAZ: <br /> SCHOOL IMPACT FEE p� <br /> Account (056) Single-Family Detached House Amount $ CJ. '16-l <br /> (057) Mobile Home <br /> (058) Other Residential <br /> ! 123) Collection Fee <br /> 1. 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 $ <br /> Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> --'�' <br /> Exempt ❑Yes ❑ No How Determined Total Amounrz� _� <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 same, <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />