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PASCO COUNTY, FLORIDA <br /> I _ _ Permit No. O <br /> z Date Permitted - <br /> Builder Name/Owner Name A 11a_*_ &6?<P Control#' " <br /> County Parcel No. 2 5 2-& 2-1 b #0 0000l SubDiv: °A <br /> Address/Location Z ;& <br /> Classiticatlon/Type of Us@ �/ e <br /> TRANSPORTATION IMPACT FEE Rae: Sq.Ft Unit: 2r i 7.Z, <br /> Exempt' ❑Yes No <br /> /How Determined <br /> Impact Fee Amount $. J� 3°Z Zone No. TAZ: <br /> SCHOOLIMPACT`FEE. <br /> Account (056) Single=Family Detached House Amount $ <br /> ' (057) Mobile;Home <br /> ► (056) Other Residential <br /> 123) Collection-Fee <br /> Exempt Yes No How Determined <br /> PARKSAND.RECREAT_ION FEE- " <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation/Total <br /> Zone __� TOTAL AMOUNT <br /> Exempt ❑Yes Q'No How Determined <br /> LIBRARY FEE <br /> Land Accounf Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> i <br /> Exempt ❑Yes (3 No How Determined Tolal:Amoun� <br /> RESOURCE`FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATtgF,OCCUPANCY_WILL 81118SUWOR.FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL'I MOUNTS,LISTED-HAVE <br /> BEEN PAP.AND <br /> RECEIPTED FOR,BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY <br /> Aektowiedgementbeiow des nqt lmply.acceptenee of concurrence,but simply receipt o!a.FPO.of this fomn,placing <br /> the bulldlnp pamilt owner on nonce of thls a ssessment-and,the bdnditlons of payment fdr eame. <br /> DATE RECEIVED`BY <br /> RECEIPT NO. DATE BY <br />