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. j PASCO COUNTY, FLORIDA <br /> Permit No. <br /> Date Permitted —Z <br /> t 'Builder Name/Owner Name Q 9u'Vitl h6wn Control#' <br /> ��,z� <br /> County Parcel No. 26 Ll 0 /1 t () suboly: <br /> Address/Location <br /> s <br /> Classificatlon/rype of Us@ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: �,'�IZ _ <br /> Exempt ❑Yes ❑No How Determined <br /> } Impact Fee Amount $,'34 1", Zone No. TAZ: <br /> SCHOOLIMPACT'FEE <br /> Account (066) Single-Famlly Detached House Amount $ <br /> (057) Mobile Home <br /> (056) Other Residential <br /> F 23) Collection Fee <br /> Exempt 6 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 /> i <br /> l <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> i <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amounv=6-- <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 /> BIB;PAID AND <br /> RECEIPTiD FOR-BY.A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of conowence,but simply receipt of a copy of tide form,placing <br /> the building permit owner on notice of We assessment and the oondillons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />