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<br /> <br /> <br />PASCO COUNTY, FLORIDA <br /> <br /> <br />. 6:;~~~~llIft~ ~.O 3 <br /> <br />Builder Name/Owner Name ~ ~I. e~r <br />Oounty Parcel No. ~tj~_ ~ :J-- ai.- 0 01 L. 00 Q'7 SubDiv: <br />: Address/Location ,.:if 7' /P I q. ~A7~.6 (h. <br /><tf:Classiflcatlon/Type of Use C-fl7~ W~ <br />'~r~'RANSPORT AllON IMPACT FEE 'Rate: Sq Ft Unit: <br />Exempt [) Yes ~ No How Determined <br />Impact Fae Amount $"! fRo ;/..o/l9/o;:,zone No. <br /> <br />Control # <br /> <br />Wq~;/~~~ <br /> <br />TAZ: <br /> <br />SCHOOL IMPACT FEE <br />(056) Single-Family Detached House <br />(057) Mobile Home <br />(058) Other Residential <br />, "Jj,23) Oollectlon Fee <br />Exempt "!/J Yes rJ No How Determined <br /> <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br />Amount $ ___..::.________ <br /> <br />Land Total <br /> <br />Recreation Account <br /> <br />Recreation Credit <br /> <br />Recreation Total <br /> <br />TOTAL AMOUNT ~_______ <br /> <br />DYes [J No <br /> <br />How Determined <br /> <br />LIBRARY FEE <br />Land Account <br /> <br />Land Credit <br /> <br />Land Total <br /> <br />Facility Account ___'___ Facility Credit __ <br /> <br />Facility Total <br /> <br />Exempt [] Yes D No <br /> <br />RESOURCE FEE <br />TOTAL AMOUNT <br /> <br />How Determined <br /> <br />Total Amollnt <br /> <br />ERU <br /> <br />\~.qs <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 />Acl\nowledgement 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 RECEWEDBY <br />RECEIPT NO. LQt:) 9104 DATE q -~-Qs BY D \0'a~- <br />