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� . PASCO COUNTY, FLORIDA <br /> y <br /> Permit No. <br /> Date Permitted �4Z-Z—Wn? <br /> ^Builder Name/Owner Name A Control#' ' <br /> County Parcel NoJ5,j.4 2-1 bf�O DLY9OQ 0,�va SubDiv: t .1 <br /> Address/Locatlon `J <br /> Classification/Type of Usq <br /> TRANSPORTATION IMPACT FEE Sq.Ft Unit: <br /> Exempt ❑files [] No How Determined <br /> �. <br /> Impact Fee Amount Az�cJ�l Zone No. TAZ: <br /> . SCHOOL IMPACT FEE <br /> Account <br /> CH <br /> f (056) Single-Family Detached House Amount $ , —1 .�_L!e <br /> (067) Mobile Home <br /> E (050) Other Residential <br /> 123) Collection Fee <br /> Exempt [ Yes. n No How Determined <br /> PARKS AND RECREATION FEE- <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation e Total <br /> Zone TOTAL AMOUNT $".76 7` <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 AIMOIINTS 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 iWe form,placing <br /> the buudkmg permit owner-on notice of this assessment and tha conditleons of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />