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RASCO COUNTY, FLORIDA, <br /> Permit No. <br /> Date Permitted — _z <br /> Builder NamelOwner Name � r �� Control W <br /> 2 bI/�1 bt%d61976 subDiv: <br /> County Parcel No. a <br /> Address/Location c3 ! Leyelk &t^znol &46e <br /> ClassWcadon(i'ype of Usq 4 o1 <br /> TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit <br /> Exempt' ❑Yes [} No How Determined <br /> Impact Fee Amount $3 0,,32 <br /> �---- Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> r 123) Collection Fee <br /> i Exempt []Yes No How Determined <br /> t. PARKS AND RECREATION FEE• <br /> Land Account Land Credit Land Total <br /> I' Recreation Account Recreation Credit Recreation-Total <br /> ! i <br /> Zane TOTAL AMOUNT $ tr <br /> Exempt ❑Yes ❑No How Determined <br /> r <br /> ! LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account Facility Credit Facility Total <br /> I Exempt ❑Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <br /> Prepared By j Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOI.INTS LISTED HAVE <br /> BRE PAID AND. <br /> RECEIPTEII 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 some. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE BY <br />