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�� RASC4 COUNTY, FLORIDA <br /> Permft No. �b Z <br /> Date Permitted %b �ff�(�- <br /> 8ullder Name/�Jwner Name �V�q2 LI�S� �-(9�JT'�-�oTffrol# T <br /> County Parcel No. ��'ZS-Z-(--�� 3U'��•��Z`d SubDiv: � � r �c�S <br /> Address/Location (�S(4(� �g 14� � 3� �y <br /> Classification/TypeofUse �dDWtMe���(�/ ���j}(� S'�' � -�� t�pL��•- (���(�_ <br /> TRANSPORTATION IMPACT FEE , Rate: � Sq Ft UNt; I `�"� <br /> Exempt � Yes [� No How Determined <br /> � Impact Fee Amount $ ��v�` �'b Zone No. TAZ: <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ JV�� <br /> (057) Mobile Home <br /> (058) Other Restdential <br /> 123) Collection Fee <br /> Exempt Yes [] No How petermined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account �_ Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $ /!}/!� <br /> Exempt (� Yes [] No How Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account 1_ Faciljty Credit Fac(lity Total <br /> Exempt � Yes (] No How Determined <br /> Total AmounE N/f+- <br /> -�_ <br /> RESOURCEFEE ERU <br /> TOTALAMOUNT <br /> Prepared By Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIpN <br /> PERFORMED UNTIL THE 70TAL AMOUNTS LISTEp HAVE <br /> RECEIPTED FOR BY q CENTRALE ERMI IT1'N(3 OFFICE OF pASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenoe,but slmply recelpt of a copy of this form,placing <br /> the building parmlt owner on notice of ihis assessment and th�condltlons af payment for same. <br /> QATE <br /> R�CEIVEQ BY <br /> RECEIPT NO _�_ pATE <br /> �_ BY <br />