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CIA COUNTY, FLORIDA <br /> ` IPermit No. /lf/�_ <br /> Date Permitted -2- <br /> Builder Name/Owner Name Control#' <br /> County Parcel No. `j fJ 1-6 r-( 6(6,0 0 0 2-6 SubDIv: L-e r 14kv <br /> Address/Location 3801 t <br /> Classfficationrrype of Use I e <br /> TRANSPORTATION IMPACT FEE . Rate: Sq.Ft Unit: <br /> Exempt ❑Yes [] No How Determined <br /> Impoct Fee Amount $_� 1�,32� _ Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ --� t ` 2 — <br /> (057) Mobile Home <br /> (056) Other Residential <br /> f 123) Collection Fee <br /> 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 $ 76 L <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total Exempt ❑Yes ❑ No How Determined Total Amount� <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTI�ICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN,PAID AND <br /> RECEIPTED FOR'SY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply recelpt 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 />