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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />I <br /> <br /> <br />Builder Name/Owner Name ~~ ~~ <br />County Parcel No. .~ "-/ ~.~ S - A ,.. 0 ~ \ 0 - t) II i- <br />Address/Location 31(0:l '7 ~:... 1/ tie. ' <br />Classification/Type of Use 1\-\010 ( (~ l~ <br />TRANSPORTATION IMPACT FEE Rate: <br />Exempt 0 Yes ~ How Determined <br />Impact Fee Amount $ I, Lf r;-o . €YO Zone No. <br /> <br />Sq Ft Unit: <br /> <br />TAZ: <br /> <br />.SCHOOL IMPACT FEE <br />Account (066) Single-Family Detached HOllse <br />(057) Mobile Home <br />(058) Other Residential <br />1:1 ~ Collection Fee <br />Exempt L1YYes 0 No How.Determlned <br /> <br />Amount <br /> <br />$ <br /> <br />--...---------- <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit Land <br /> <br /> <br /> <br />Recreation Account <br /> <br />Recreation Total <br /> <br />Zone <br /> <br />TOTAL AMOUNT <br /> <br />$ <br /> <br />Exempt ~s 0 No <br />,~ <br />LIBRARY FEE <br />Land Account <br /> <br />How Determined <br /> <br />Land Credit <br /> <br />Facility Account ______ F ' <br /> <br /> <br /> <br /> <br />Facility Total <br /> <br />Exempt <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />SOURCE FEE <br />TOTAL AMOUNT <br /> <br />\~~ . <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 llot 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 />RECEIVEDBY <br /> <br />..,.....",., <br /> <br />'" ,~~_: .;.'-;':,;,--'-;~{~y.{:-~' <br /> <br /> <br />o Arg--- <br /> <br />RECEIPT NO, l,o'6q,\O~ DATE ~ '~-~ BY 'Q"-\('f^- <br />