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: L(I i <br /> ` PASCO COUNTY, FLORIDA <br /> - L [; i � 0 Permit No. ���� � <br /> Date Permitted = <br /> �a�rl �, 5�(�?eS Control # ' <br /> Builder Name /Owner Name �, <br /> ( - . 3a r '��ubDiv: f w. <br /> 3 16 County Parcel No. 0 'Z + � �► „j - • i 1 �' .� � ,� b� <br /> Address /Location ..• f ` <br /> Classification/Type of Use <br /> n- kawi e., <br /> TRANSPORTATION IMPACT FEE , <br /> Rate: �'l Sq Ft Unit 41 <br /> Exempt ❑ Yes ❑ No How Determined <br /> Q C)t? �___ TAZ: <br /> ' impact Fee Amount $ J� 4 V � ' Zone No. <br /> SCHOOL IMPACT FEE Amount <br /> Account (056) Single - Family Detached House <br /> (057) Mobile Home • <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt L] Yes ❑ No How Determined <br /> PARKS AND RECREATION FEE Land Total ,-- <br /> Land Account Land Credit <br /> Recreation Credit Recreation Total <br /> Recreation Account <br /> Zone TOTAL AMOUNT 121 <br /> :5-52--- <br /> Exempt ❑ Yes ❑ No HoW Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account <br /> - Facility Credit Facility Total <br /> 10 r <br /> Exempt ❑ Yes ❑ No How Determined � Total Amount <br /> RESOURCE FEE . ERU <br /> TOTAL AMOUNT <br /> Prepared By t ` ` Checked By <br /> WILL BE ISSUED OR FINAL <br /> NO CERTIFICATE OF OCCUPANCY W INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE PASCO COUNTY <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 /> DATE . RECEIVED BY <br /> RECEIPT NO. DATE BY <br />