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FASCO COUNTY, FLORIDA <br /> Permlt No. � <br /> Data Permitted <br /> �'Builder.Name/Owner. Name. �L[`f� _ ,�— Control#' <br /> County Parcel No. 2.b 2,6 g2, 66 ?e SubDIv: <br /> Address/Location <br /> Classlflcation/Type of Us@ - r <br /> TRANSPORTATION IMPACT FEE Rate: Sq:Ft Unit: <br /> Exempt .❑Yes Q No How Determined <br /> impact Fee Amount � Zone No. TAM <br /> SCHOOL IMPACT;FEE . . <br /> Account {656) SI`rigle=Famlly Detached House Amount $ � <br /> • (057) Moblte=Home <br /> (058) Ottiar,Resldentlal <br /> 123)" .Collection Fee <br /> ` Exempt Yes: Q No How Determined <br /> PARKS AND,RECREEATION FEE• <br /> Laird Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL•AMOUNT $ l <br /> Exempt [}Yes Q No How Detelmined-70 <br /> `'.. LIBRAttYMEE <br /> ` Land Account Land-Credit Land Total <br /> Facility Account Facility Credit Facility Total j <br /> Exempt ❑Yes Q No How Determined Total AmountC:(�'" <br /> RESOURCE-FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By t Checked By <br /> NO CERTIFICATE QF QCCUPANCY WILL BE ISSUED OR f INAL_INSPECTION <br /> PERFORMED UNTIL THE`TOTAL AM04NTS LISTED HAVE <br /> 8EEN'IAID AND <br /> RECGIPTED.FOR 9Y A CENTRAL:PERMITf'IN®OFFICE.OF PASCO COUNTY <br /> Acici"adgement below does not imply acceptance of concurrence,but simply recolpt of•a copy of thle form,placing <br /> the building permit owner on notice of this easessment and the conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />