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; <br /> �: RASCO COUNTY, FLORIDA <br /> Permit No. / � � � � <br /> Date Permitted 3- 30 - t/ <br /> Builder NamelOwner Name �2�1�1�-r `��ft'`"`� ��� Control # <br /> county Parcel No. G' 3 Z���' 3 d " <br /> �C9C�� ° Z� c3�U SubDiv: � � ���u � � � <br /> Address/Location � � � � 7 � � � � � n � �� �" � � � � <br /> Classification/Type of Us� IZE Si G�2n'h �k IO �i. �`� h �' '`�C <br /> TRANSPORTATION IMPACT FEE . Rate: Sq Ft Unit; � 37 � <br /> Exempt [] Yes [] No How Determined <br /> Impact Fee Amount � 3`� �Q � Zone No. T/�� <br /> SCNOOL IMPACT FEE <br /> Account (056) Single-Family petached House Amount $ ��.' 7�b <br /> (057) Moblle Home <br /> (058) Other Residentlal <br /> 123) Collectiorl Fee <br /> Exempt a Yes [] No How Qetermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ � b� �S(o <br /> Exempt � Yes [� No How Determined <br /> LIBRARY FEE <br /> L.and Account Land Credit Land Total <br /> Facility Account Facllity Credlt Facllity Total <br /> Exempt � Yes �] No How Determined Total Amount � <br /> RESOURCE FEE ERU <br /> TO7ALAMOUNT � <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 /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below doea not Imply acceptance of concurrenoe, 6ut slmply recelpt of e copy of this form, placing <br /> the bullding permit owner on notice ot thls assessment and th� condlUons pf payment for same. <br /> DATE R�CEIVELI BY <br /> RECEIPT NO DATE BY <br />