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;�. <br /> : RASCO COUNT'Y, �LOIRIDA <br /> _ . . . Permit No. � Z ' <br /> Date Permittad J—ZZ--� g <br /> Builder NamelOwner Name�"`I �(A�C.YVt�r►►,c��r�cv�eC7 Control# <br /> '. Counry Parcel No. 3�-Z.SZI-b f 7o-000dt�..Z(,7o SubDiv: �, , r�� <br /> �; Addrass/Location <br /> _ 3"7�Z� o � 1 � �-af 2 6 7 <br /> '"~= ClassiflcatioNType of Use YVtD�� '� `t-�Cv�� <br /> �; • <br /> e,: <br /> ;-'.:. TRANSPORTAT�ON IMPACT FEE Rate: Sq.Ft Unit: 1, ��'3 <br /> ?,�� <br />'� :�=�` Exempt � Yes � No How Determined <br /> �z,.. <br /> '�: � Impact Fee Amount _$.,�� (fl 32 •�C� Zone No. Tp,Z; <br /> a�:� <br /> '='= � SCHOOL IMPACT FEE <br /> `t� Account (056) Single-Family Detached House Amount $ _ „� <br />, _ (057) Mobile Home <br /> '� (058) Other Resldential <br /> 123) Collection Fee <br /> Exempt [�Yes �No How Determined <br /> PARKS APID RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit �Recreation Total <br /> ; Zone TOTAL AMOUNT $ �7�. `l �j <br /> _ Exempt �Yes [] N4 How Determined ' <br /> LIB <br /> RARY FEE <br /> ' Land Account Land Credit Land Total <br /> k. <br /> Fac(liry Account Facility Credit Facility Total <br /> Exempt � Yes No How Determined <br /> ❑ <br /> T�t�l Amoun <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT <br /> Prepared By � Checked By <br /> ,. NO CERTIFICATE OF OCCUPANCY WILL�E ISSUED OR FINAL INSPECTION <br /> ' PERFORMED UNTIL THE TOTAL AMOUN7S LISTED HAVE <br />, ;_. BEEN PAID AND � <br /> "� RECEIPTED FOR BY A CENTRAL PERMITTtNG OFFICE.OF PASCO COUNTY <br />� �; � <br /> i:� Acknowledgement bsiow does not Imply acceptance of concurrence,but simpiy recelpt of a copy of this form,placing <br /> the bullding pertnit owner on noUce of this assessment and thQ conditions of payment for same. � <br />� t, <br /> � DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br /> . �. <br />