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PASCO COUNTY, FLORIDA <br /> Permit No. u 0 <br /> tt Date Permitted <br /> ~Builder Name/Owner Name -1- 4- Control W " <br /> County Parcel No. 2q 2,4 Z_I d 1 I o Do 00d 2-2-30 subDiv: <br /> Address/Location <br /> Classification/Type of Usq <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft unit: rl_ <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 $ i /r <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 4 f 23) Collection Fee <br /> 1 Exempt [ Yes ❑No How Determined <br /> , <br /> !. PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> i <br /> l Recreation Account Recreation Credit Recreatlon�Total <br /> E r <br /> Zone TOTAL AMOUNT $ (7e <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 Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BOOK;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 />