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i <br /> PASCO COUNTY, FLORIDA <br /> Permit Na. " <br /> � t7 <br /> to Permitted <br /> i <br /> �Buiider Name/Owner NameCantrol#' <br /> County Parcel No. �`SZf d_j36 aL000 Dd 7v SubDiv: ��'�t`�'� <br /> Address/Locatlan 76 4-11 Z v <br /> Classification/Type of Usq C 1� '� k' /Iezt)'e T <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: Z <br /> Exempt []Yes ❑ No How Determined <br /> impact Fee Amount $. 32112-1160 Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family petached House Amount $ <br /> (057) Mobile Home ` <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes ❑Na Haw 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 /> i <br /> LIBRARY FEE j <br /> E Land Accounf Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amounf~� ; <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> 1 <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 We 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 />