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RASCO COUNTY, FLORIDA, <br /> Permit No. <br /> Date Permitted <br /> �Builder NamelOwnor Name n Control W <br /> County Parcel No. 2q2-�Zj(� /l)�/�d t�d� ' SubDiv: <br /> Address/Location y/ 3/� /-A-/"f/- C,��� �l°�f-10-4 1 <br /> CtassificattoNType of UsQ t5i V <br /> dosL— <br /> TRANSPORTATION IMPACT Rate: Sq.Ft Unit: <br /> Exempt ❑Yes ❑No How Determined <br /> i <br /> 'i Impact Fee Amount 4-3; Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ _6r4z' 2-6 <br /> (057) Mobile Home <br /> (066) Other Residential <br /> t 123) Collection Fee <br /> 4 Exempt [ Yes Q No How Determined <br /> E. PARKS AND RECREATION FEE <br /> t Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation-Total <br /> 1 Zone TOTAL AMOUNT $ WL <br /> w, Exempt ❑Yes ❑No How Determined <br /> LIBRARY FEE <br /> ( Land Account Land Credit Land Total <br /> h Facility Account Facility Credit Facility Total <br /> Exempt ❑Yes ❑ No How Determined Total Amount <br /> RESOURCE FEE ERU <br /> TOTAL AMOUNT <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 /> 111091tPAID AND <br /> RECEIPTED FOR.8Y 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 />