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;� � �: RASCO COUNTY, FLORIDA <br /> • Permit No. � 7 � 7� <br /> Date Permilted <br /> Builder Name/Owner Name �L(�u-+� Y-M�— Control # <br /> County Pa�cel No. (� <br /> �j-Z(Q �` �a"'� <br /> Address/Location �e Z5Z � � �'��/ �'e- c � � d � �� <br /> Classificatlon/Type of Us� �e-�► � TM l�� r��'� <br /> TRANSPORTATION (MPAGT FEE � Rate: Sq Ft Unit; ��0 <br /> Exempt [] Yes � No HoW Determined <br /> Impact Fee Amount $`�, � �.C�. Zone No. TAZ: <br /> SCHOOL IMPACT FEE .-� �j 7� � b <br /> Account (056) Single-Famlly Detached House Amount $ � , <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) collection Fee <br /> Exempt Yes [] No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Rec�eation Credit Recreatlon Total <br /> Zone TOTAL AMOUNT $ � �2 f °S <br /> Exempt � Yes � No How Determined <br /> LIBRARY F�E <br /> Land Account Land Credit Land Total <br /> Facility Account Faciljty Credit FaclUty Total <br /> Exempt � Yes ❑ No How Determined Total Amount � <br /> RESOURCEFEE 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 /> RECEIPTED FOR BY A CENTRAL PERMITTIN(3 O�FICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenCe, but slmply recelpt of e copy of thl� form, placln� <br /> lhe bullding permlt owner on nollce of this assessment and th� condltlons pf paymenl for same. <br /> DATE R�C�IVEQ BY <br /> RECEIPT NO. DATE BY <br />