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a <br /> � . PASCO COUNTY, FLORIDA <br /> Permit No, t l <br /> t Date Permitted '-- <br /> ^Builder Name/Owner Name t) 1� Control#' <br /> County Parcel No. �6 Z-6 Zt D t cf'D QA000 Z2U f/ SubDiv: <br /> Address/Location 7 6(o r,9 a: 4 <br /> Classificationlrype of Us@ ` ��- <br /> TRANSPORTATION IMPACT FEE , Rate: Sq.Ft Unit: <br /> Exempt ❑Yes 0 No How Determined <br /> Impact Fee Amount . 3 Zone No. TAZ: <br /> C <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ c <br /> (057) Mobile Home <br /> (068) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes- Q 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 s"7�z Jz <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 Amountl�_. <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By C ;)�_ Checked By <br /> v <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 ofa copy of Oft form,placing ~ <br /> the building permit owner-on notice of thle easement and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />