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RASCO COUNTY, FLORIDA,, <br /> Permit No. f<S l <br /> w Date Permitted <br /> Builder Name/Owner Name #Ti" '� Control#• " <br /> County Parcel No. Q�ry 2�z- ��f1 xX J C_b SubDIv: .�, > _r <br /> Address/Locatlon k/ <br /> Classiflcation/Type of Use S/ <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2 <br /> Exempt ❑Yes 0 No How Determined <br /> Impact Fee Amount , Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ e), q11, �5 <br /> ' (057) Mobile Home <br /> (056) 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 <br /> /Total <br /> Zone _ TOTAL AMOUNT $ <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 Chocked By <br /> NO CERTIFICATE.OF OCCUPANCY WILL SE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> SEEN 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 /> lhe 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 />