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_� � � = RASCO COUNTY, FLORIDA <br /> Perm�t No 1 b R <br /> Date Permit�ed - � - 1 <br /> Builder Name/Owner Name �'� �'� +��-�" TU' V`'�-��- Control # <br /> � 2. Z 7 SubDiv: t-i lQn� ��� <br /> County Parcel No. U �- 1 " Z�"'� �� <br /> Address/Location � � � ! � � r � ` � � �� ���� � � � � <br /> Classification/Type of Use �e-� �`E n� �^-� � �� �� <br /> TRANSPORTATION (MPACT FEE . Rate: Sq Ft Unit; � 5 3 <br /> Exempt [] Yes � No HoW Determined <br /> � Impact Fee Amount $�J 4�� • Zone No. T�� <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ �����- � � <br /> (057) Mobfle Home <br /> (058) Other Residential <br /> 123) Collectio�l Fee <br /> Exempt [� Yes [] No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ � (o � ..5 io <br /> Exempt [] Yes � No How Determined <br /> LIBRARY FEE <br /> Land Account �and Credit Land Total <br /> Facility Account Faciljty Credit Facility Total <br /> Exempt � Yes �] No How Determined Total Amount �^ <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT ' <br /> Prepared By �- - Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL 8E ISSUED OR FINAL INSPECTIQN <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTIN(3 OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenoe, but slmply recelpt of a copy of thl� fonn, placing <br /> lhe bullding permit owner on notice of this assessment and tha condlUons pf paymenl for same. <br /> DATE R�CE�VED BY <br /> RECEIPT NO DATE BY <br />