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.� RASCO COUNTY, FLORIDA <br /> � � Permit No. ��� <br /> Date Permitted i o-( 2- I 1 <br /> Builder Name/Owner Name ��,��GZ.� `���'1 E. Control # <br /> County Parcel No,(�.��Z�- ZI -�02�'�C.�' c�OCXi�° ( 2100 SubDiv: �- , j�wld �G��rl� 1GLt%�l���Q�� <br /> AddressJLocation � �� 3� �y� U� �{ �,�G� �� !'l'� #� 2 b <br /> Classification/Type of Usg Y��� Q ��'�� ��� <br /> TRANSPORTATION IMPACT FEE . Rate: 9`] �( 5 Sq Ft Unit: �� Ip� <br /> Exempt � Yes [� No How Determined <br /> Impact Fee Amount _$. 3,�'� �• Zone No. TAZ: <br /> SCHOOL IMPACT FEE • <br /> Account (056) Single-Famlly Detached House Amount $�.� � 7�Q ^ <br /> (057) Moblle Home <br /> (058) Other Residentla) <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 �_ Recfeation Credit Recreation Total <br /> Zone TOTAL AMOUNT _� �J (o q, ,� (p <br /> Exempt � Yes [� No How Determined ' <br /> LIBRARY FEE <br /> Land Account �and Credit Land Total <br /> Facility Account �_ Facfliry Credit Facfliy Total <br /> Exempt � Yes [] No How Determined Total Amount � <br /> RESOURCE FEE � ERU <br /> TOTALAMOUNT <br /> P�epared By Checked Sy <br /> l <br /> NO CERTIFICATE OF OCCUPANCY WILL BE IS3UED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL qMOUNTS LISTED HAVE <br /> RECEIPTED FOR BY A CENTRAL ERMITT N(3 O�FICE.OF PA5C0 COUN'fY <br /> Acknowledgement below doea not Imply acceptance of concurrenae, 6ut slmply recelpt of e copy of this form, placing <br /> Ihe bullding permit owne� o� noUce of thls assessment and th� condiilons of payment for seme. <br /> QATE <br /> R�CEIVEp BY <br /> RECEIRT NO. __�_ pATE BY <br />