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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Permit No. <br />, Date Permitted <br /> <br />Builder Name/Owner Name (2~ ~/4~~---ZS Control # <br />County Parcel No. ~.~-~ tf,- ~/ -01) q IJ "-o/}t)c')t)-- ~r-S lot/I SubDiv: <br /> <br />/.b~1 <br />In -,;2 -tJ~ <br />. <br /> <br />~r;.6Wi ~~ <br /> <br />Address/Location <br />ClassificationfType of Use ~7Ju~./O~ _ <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Rate: <br /> <br />Sq Ft Unit: <br /> <br />Exempt 0 Yes 0 No <br /> <br />How Determined <br /> <br />Impact Fee Amount $ <br /> <br />Zone No. <br /> <br />TAl: <br /> <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />.J:123) Collection Fee <br />Exempt U Yes 0 No How Determined <br /> <br />Amount $ <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br />Land Total <br /> <br />Recreation Account <br /> <br />Recreation Credit Recreation Total <br /> <br />Zone <br /> <br />TOTAL AMOUNT $ <br /> <br />Exempt 0 Yes 0 No <br /> <br />How Determined <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />Land Credit <br /> <br />Land Total <br /> <br />Facility Account <br /> <br />Facility Credit <br /> <br />Facility Total <br /> <br />Exempt 0 Yes 0 No <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />ERU <br /> <br />Prepared By <br /> <br />Checked By <br /> <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 /> <br />Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing <br />the building permit owner on notice of this assessment and the conditions of payment for same. <br /> <br />DATE <br />RECEIPT NO. <br /> <br />RECEIVED BY <br /> <br />DATE <br /> <br />BY <br />