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a <br /> " PASCO COUNTY, FLORIDA <br /> Permit No. . <br /> Date Permitted `- <br /> Builder Name/Owner Name Control#' <br /> t County Parcel No. 3 5 25 2-1 f l6g 01('M yDZ&ubDiv: r <br /> ::,.. 3��l� �n�� LfQ.�rd?Sra <br /> AddresslLocat}on < <br /> Classification/Type of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: s <br /> Exempt ❑Yes ❑ No How Determined <br /> Impact Fee Amount $.3L,�J2i Zone No. TAZ: <br /> SCHOOL IMPACT FEE r <br /> Account (056) Single-Family Detached House Amount $ /� <br /> (057) Mobile Home <br /> (056) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes ❑No Haw Determined <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> t <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ �1 � <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 l ��._ 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 />