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PASCO COUNTY, FLORIDA <br /> Permit No. --3 <br /> - n Date Permitted <br /> Builder Name/Owner Name (dr /C Control <br /> County Parcel No. 5 Z-52 1 � _6z) lX�7t�t'S D3'� SubDiv: t- <br /> Address/Location �1.�?/��`� <br /> t Classitication/Type of Use (% 'e <br /> TRANSPORTATION IMPACT FEE Rate: Sq,Ft Unit: Z <br /> Exempt ❑'fes ❑ No /How Determined <br /> Impact Fee Amount $. 3 �3� Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ l� 2� <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> t <br /> Exempt [�Yes Q No Haw Determined <br /> t. PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT s7 - <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 /> 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 some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />