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: 'RASCO COUNTY, FLORIDA <br /> t <br /> t Permit No. <br /> Date Permitted ZOY <br /> Builder Name/Owner Name Control#' " <br /> County Parcel No. -Q 70- ,0. ubDiv: <br /> Address/Location • ,52 <br /> Classification/Type of Usg <br /> TRANSPORTATION IMPACT FEE Rate: SQ.Ft Unit: _ <br /> Exempt n Yes -[] No How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other.Residential <br /> 123) Collection fee <br /> Exempt (�Yes - Q'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 $ is <br /> Exempt ❑Yes [:]No How Determined' <br /> LIBRARY'FEE <br /> Land Accounf 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 t' Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOt.INTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PER MITTiNO OFFICE•OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but simply reoelpt of•a copy of this form,placing <br /> Chi bullding permit ownsFon notice of ttils assassment and the condlUons of payment for same. <br /> DATE• RECEIVED BY <br /> RECEIPT NO. DATE BY <br />