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RASCO COUNTY, FLORIDA <br /> k Permit No. .-8(a <br /> Date Permitted -Z& <br /> Builder Name/Owner Name 64AV�l Control#' <br /> County Parcel No: 5 2-- Z6-Zl '(,d 17�6f boo-COIL ubDiv: ► iJ <br /> Address/Locadon .5 lotaA <br /> Ciassification/Tf'YPe of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: O i l <br /> Exempt []Yes! [] No r How Determined <br /> Impact Fee Amount Zone No. TAZ: <br /> { <br /> SCHOOL IMPACT,FEE <br /> Account (056):, Single-Family Detached House Amount $ <br /> (057) ; Mobile Home <br /> i (058) Other Residential <br /> 123) Collection Fee <br /> ` Exempt ( Yes,_.0 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 $ ','(r�9• S,G <br /> Exempt Q Yes ; []No How Determined"O <br /> LIBRARY FEE <br /> Land Accoun# Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes : ❑No How Determined Total Amou " <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY.WILL.BE.ISSUEQ;OR,FINAL,INSPECTION <br /> PERFORMER UNTIL THE TOTAL AMOUNT$LISTED HAVE <br /> BEEN PAID AND-, <br /> RECEIPTED FOR 13Y A CENTRAL PERMirnNGl OFFICE.OF PASCO COUNTY <br /> AckrMWedgement below,does ndt lmp!y acceptance of concurrence;but simpiy.receipx ofa copy of thls form,;piacing <br /> the buUftg permlt ow6er do nodes of thle assessment and the condillons of payment for earima. <br /> DATE RECEIVED'SY <br /> RECEIPT NO. DATE BY <br />