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4 <br /> RASCO COUNTY, FLORIDA <br /> _ Permit No. . <br /> r/ Date Permitted -- ,J <br /> 'Buiider Name/Owner Name 1-01% - &d Control W <br /> County Parcel No. Zj 4, V ()/t (, go0())2 --'0SubDIv: <br /> Address/Locatlon ol?. /5 ZA <br /> ClassiflcationfType of Use <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: <br /> Exempt ❑fifes ❑ No How Determined <br /> Impact Fee Amount -,54 6C Zone No. TAZ: <br /> SCHOOL IMPACT FEE l Account (056) Single-Family Detached House Amount $ ce. !/ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 23) Collection Fee <br /> Exempt 'dyes 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 $ c <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—C—.-' <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCYINILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMO>.)NTS LISTED HAVE <br /> BftN;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 buRdlhg permit owner-on notice of this assessment and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />