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i <br /> j PASCO COUNTY, FLORIDA <br /> _ Permit No. <br /> - Date Permitted ' — <br /> ~Builder Name/Owner Name 1 T111' Control#' <br /> County Fafce!No. S 6- 'Z1. 0 1&a d tl OQ �ubDiv: <br /> Address/Location `3 911aa Spnn E.f— <br /> Classiticationrfype of Use dr t" c t <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑ltes ❑ No How Determined <br /> Impact Fee Amount $. Jai �3� Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 0 23) Collection Fee <br /> Exempt dyes ❑No How Determined <br /> i <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> f' Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 76, ' <br /> Exempt ❑Yes ❑ No How Determined. <br /> LIBRARY FEE <br /> Land Accounf 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 A Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> SORKPAID AND', <br /> RECEIPTED FOR.BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Acknowledgement below does not imply acceptance of concurrence,but simply receipt ofa 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 13Y <br />