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<br /> <br />PASCO COUNTY, FLORIDA <br /> <br />Builder Name/Owner Name ,Shft,.(-ty w/11ffrt-tr/ <br />County Parcel No. __'___________ <br />Address/Location 380 ~ 2> ~~ L A). <br />~ <br /> <br /> <br />ClasslflcatlonlType of Use ~IoL~_14~. <br /> <br />SubDlv: <br /> <br />TRANSPORTATION IMPACT FEE <br /> <br />Rate: <br /> <br />Sq Ft Unit: _ <br /> <br />Exempt [] Yes [~o How Det~rmlned <br />Impact Fee Amount $ C)if ~. ~:9')f . .i.<one NO., <br />./.., /"-"/'/- L-7 <br />-tr ,J~ ~, <br /> <br />TAZ: <br /> <br />----------- <br />SCHOOL IMPACT FEE <br />Account (056) Single-Family Detached '-louse <br />(057) Mobile Horne <br />(058) Other Residential <br />.1123) S2!!eSUon Fee <br />Exempt LJ Yes LJklo How Deterrnlned <br /> <br />Amount <br /> <br />$ _Jfr1 . ~ <br />,.:ii7~-::;7' c:rj <br /> <br />~-""'l"f'.4:>.-:--"""'" <br />PARKS AND RECREATION FEE <br />Land Account Land Credit <br /> <br />Land Total <br /> <br />----".~-- <br /> <br />Recreation Account <br /> <br /> <br />--------- <br /> <br />Recreation Total <br /> <br />Zone <br /> <br />TOTAL AMOUNT ,~_________ <br /> <br />__ Yes [J No <br /> <br />L1S'RARY FEE ~- <br />Land Account <br /> <br /> <br />How Determined <br /> <br />'I" ______ <br /> <br />---.-,.. ~",....... <br /> <br />-... -_. w <br /> <br />Facility Account <br /> <br /> <br />Land Credit <br /> <br />Land Total <br /> <br />-.---.,---- <br /> <br />Facility Total , <br /> <br /> <br />[] Yes 0 No <br /> <br />How Determined <br /> <br />Total Amount <br /> <br />RESOURCE FEE - <br />TOTAL AMOUNT <br /> <br />. .Lf~ ,- <br />:t.~ <br /> <br />ERU <br /> <br />------..,_.._~- <br /> <br />__ 1tI~_.....__.,. <br /> <br />~--..._-----,- <br /> <br />Prepared By ,_,_______~___, <br /> <br />Checked By <br /> <br />NO CERTIFICATE OF OCCU~ANCY 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 reGelpt 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. '~33 <br /> <br />RECEIVED BY <br />DATE 5-\\ -aLl BY ~\j.) '0,"'.... <br />