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{ <br /> RASCO COUNTY, FLORIDA <br /> f Permit No. <br /> Date Permitted <br /> Builder Name/Owner Name Pff Ik #M� Control#' <br /> County Parcel No. QV�SubDiv: <br /> Address/Location <br /> Classification/Type of Use v�Y <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt M Yes -[] No How Determined <br /> impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT-FEE <br /> Account {056} 2-6 <br /> Single-Family Detached House Amount $ � 1��t <br /> (057) Mobile Home <br /> (058) Otlier.Residential <br /> 123) Cbilectian Fee' <br /> Exempt [ Yes ..0No 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 ' $ 7j V <br /> Exempt ❑Yes ❑No How Determine-A <br /> LIBRARY FEE <br /> Land Accounf Land Credit Land Total <br /> Facility Account Facility.Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amoun � <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE.ISSUEQ 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 /> Acknowiedgement below.doss not imply acceptance of concurrence,but simply receipt of acopy of this foim,placing the bWldlnd permit owner on notice of this assessment and the conditions of payment for some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />