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_ PASCO COUNTY, FLORIDA <br /> Permlt No. U <br /> - ppff p f d Date Permitted T <br /> "Builder Name/Owner Name K gf�L46 Control#' <br /> County Parcel No. � ` SubDiv: ! Tc. <br /> AddresslLocation jj /l1l <br /> Classification/Type of Uso cS !e <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: / <br /> Exempt' ❑Yes Q No How Determined <br /> Impact Fee Amount �, / �' Zone No. TAZ: <br /> e <br /> SCHOOL IMPACT FEE <br /> Account (Q56). Single-Family Detached House Amount $ <br /> (067) Mbblle-Home <br /> I (068) Other Residential <br /> 123) Collection Fee <br /> Exempt []Yes. Q No How Determined <br /> PARK$�AND RECREATIOKFEE- <br /> Lan'd Account Land Credit Land Total <br /> Recreation Account Recreation.Credit Recreation Total <br /> Zone �__T TOTAL AMOUNT $ <br /> Exempt ❑Yes ❑'No How Determined <br /> LIBRARY FEE <br /> Land Accounf LandCredlt Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes Q-No How Determined Total Amount c � <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED-OR:FINAL;INSPEO.TION <br /> PERFORMEii UNTIL THE'T6T4 AMOt;(NTS LISTED HAVE <br /> REGNPAID.AND <br /> RECEIPTED FOR BY A CENTRAL PERMiTIN©OFFICE.OF PASCO COUNTY <br /> AckrWedgament below does not imply sco tsws of concurrence,but simply receipt of a cspy_of this form;pla ft <br /> the buiidtnti permit awner:on notice of this assessment and the conditions of payment tar some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />