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4� <br /> ;� : RASCO COUNTY, �LORIDA <br /> Permit No. 2 7 <br /> Date Permitted <br /> Builder Name/Owner Name � c?i�l �'la� Control # <br /> County Pa(cel No. � 3- Zf� "- Z �—� 2 �`� V U�� `�ubDiv: l <br /> Address/Location (p Z5 �p � i � � �U �-�' 1 � `� `� � � � t � - <br /> Classificatlon/Type of Usg �S �� °� ! u'^'� � �� <br /> TRANSPORTATION IMPAGT FEE � Rate: Sq Ft Unit; _ � , b3 <br /> Exempt � Yes � No How Determined <br /> Impact Fee Amount $ 3 it gU � Zone No. TAZ: <br /> SCHOOL IMPACT FEE ) <br /> Account (056} Sfngle-Famlly petached House Amount $ 1���7� �� <br /> (057} Mobile Home - <br /> (058) Other Residentlal <br /> 123) Collection Fee <br /> Exempt [� Yes [] No How qetermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ �� �'J � S� <br /> Exempt � Yes � No How Determined <br /> LIBRARY F�E <br /> L.and Account l.and Credit Land Total <br /> Facility Account Facll�ty Credit Facllity Total <br /> Exempt � Yes � No How Determined Total Amount G—{�' <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT � <br /> Prepared By � � Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIP7ED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNT�( <br /> Acknowledgeme�t below does not Imply acceptence of concurrence, 6ut simply recelpt of a copy of this form, placing <br /> the bullding permit owner on nolice of thls assessment and the conditions pf payment for seme. <br /> QATE R�CEIVEQ BY <br /> RECEIRT NO __ pqTE BY <br />