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ti RASCO COUNTY, FLORIDA <br /> r <br /> _ Permit No. <br /> t Date Permitted <br /> Builder Name/Owner Name 10ZA a�ts�lk Control#' <br /> County Parcel No. c1 Z-5 Z-1 Qrab 0000e)0/16 SubDiv: <br /> Address/Location 74/y0 <br /> ' Classification/Type of Use /&g of e-, L"1 <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> i Exempt ❑1'es ❑ No How Determined <br /> Impact Fee Amount $..! _ } Zone No. TAZ: <br /> I SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $' <br /> f (057.) Mobile Home . <br /> E (058) Other Residential <br /> �Nis <br /> 23) Collection FeeExempt ❑No. How betermined- <br /> PARKS AND RECREATION FEE. <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ <br /> Exempt ❑Yes ❑ No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facillty.Credit, Faciiity'Total <br /> Exempt ❑ Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE . ERU <br /> TOTALAMOUNT <br /> Prepared By 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 />