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RASCO CG1U�lTY, FLORIDA <br /> Permit No. 2 7`(y <br /> Date Permitted — 27—W <br /> Builder Name/Owner Name �•t 11)G(1Y► �S7Tu cY1�Control# . r1 <br /> County Par,.cel No. 11-4_�1_06/0^2_16 s04176 SubDIV: ` <br /> Address/Location <br /> Ciassfficatlord ype of Use k° ��✓rrr <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑Yes [] No How Determined <br /> � l. <br /> Impact Fee Amount $. t7✓�� Zone No. TAZ: <br /> E SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (056) Other Residential <br /> 23) Collection Fee <br /> Exempt d Yes ❑,No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ 7� • <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility.Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑No How Determined Total Amount ° <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By j Checked By <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 /> 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 />