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_� �. RASCO COUNTY, FLORIDA <br /> Permit No. I Z � l O <br /> Date Permitted <br /> Builder Name/Owner Name ��'�� � e�M�'''� Control # <br /> County Parcel No. �3 2b l��o 13c� SubDiv: �+�a �K <br /> Address/Location �v �� � � l�'C_o�G i` n Q ( e-� '� � 3� <br /> Classification/Type of Usg � 1�(� t o� n h �rrne - 2eSi den W� <br /> TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit; f, 4d I <br /> Exempt � Yes � No HoW Determined <br /> Impact Fee Amount $ 3`� �D� Zone No. TAZ: <br /> SGHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ � r ] �7 •�-o <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collaction Fee <br /> Exempt � Yes � No How petermined <br /> PARKS AND RECR�ATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreatlon Total <br /> Zone TOTAL AMOUNT $ � �G � � •S�v <br /> Exempt � Yes � No How Determined <br /> LIBRARY F�E <br /> �.and Account Land Credit Land Total <br /> Facility Account Facility Credit Facllify Total <br /> Exempt (] Yes ❑ No How Determined Total Amount � <br /> RESOURCE FEE ERU � <br /> TOTALAMOUNT ' <br /> Prepared By � Checked 8y <br /> NO CERTIFICA7E OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMUUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence, but slmply recelpt of e copy of this form, placing <br /> ihe building permlt owner on notice of ihis assessment and tha condlqons of paymenl for seme. <br /> QATE R�CEIVED BY <br /> RECEIPT NO DATE gy <br />