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.: RASCO CC�UNTY, FLORIDA <br /> Permit No. I 1�� 3 <br /> Date Permitted "3-.�U - l t <br /> Bullder Name/Owner Name G. P r'l (�� r t� 0 IYI�S C��'�L_ Control # <br /> county Parcel No. b 3- Z 1- L�-�C d�UJ � t�n ti�� <br /> Address/Location 3' �I I 9 `�- �-r � �,�n ' "'` � �� � �' � �� <br /> ClassificationlType of Us� �� S' ��'�� � � ���' `�e- <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit; � S� <br /> Exempt � Yes [� No HoW Determined <br /> ' Impact Fee Amount $ 3 T�C> , Zone No. TAZ: <br /> SCHOOL IMPACT FEE � <br /> Account (056) Single-Family petached House Amount $ �� S ���d <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collectior� Fee <br /> Exempt [� Yes [� No How Determined <br /> PARKS AND RECR�ATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $�] (P 9. 5� <br /> Exempt � Yes � No How Determfned <br /> LIBRARY FEE <br /> l.and Account Land Credit Land Total <br /> Facility Account Facility Credlt Facllity Total <br /> Exempt � Yes �] No How Determined Total Amount �_ <br /> RESOURCEFEE ERU <br /> TO7ALAMOUNT <br /> Prepared By ' J�' Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WII.L BE ISSUED OR FINAL INSPECTIQN <br /> PERFORMED UNTIL 7HE TOTAL AMOUNTS LISTED HAVE <br /> RECEIP7ED FOR BY A CENTRAL RMIT'f N(3 OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenFe, but simply recelpt of a copy of this form, piacing <br /> lhe building pertnft owner on notice of thls assessmenl and tha conditlons pf payment for same. <br /> QATE R�CEIVED BY <br /> RECEIPT NO. __ DATE BY <br />