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. 4 <br /> ♦ * <br /> r�'G1 . <br /> PERMIT APPLICATION �`� <br /> .—� <br /> _ � , _ <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WQ►Y <br /> All information must be filled-in completely <br /> City of Zephyrhills <br /> 5335 8"'Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> -n'. F.., .k"t.:-.. , . .. . _ ' '.,}_ ' _ . "' ., . - .. _ - . ..- <br /> dDate of application::�.-. :��( : �P'riicessed�_B,y�, .� �; _ _ `�Permit.#:�_ - - _ � '. � . -� <br /> , . .. .. (y!aYa ��fort seonly) _. ' � . ,. <br /> � _ � `�Copy'to;Buildi'rig;Deparbnent � - � ` �oPy.to Fublic Wor:ks- n�����{�} ;�`—�� <br /> _ ,t�-�l_. <br /> PRO]ECT )OB SITE: PROP TY OWNER <br /> Address: l. Name: <br /> Unit#: Address: Unit: � <br /> Parcel Identification Number: � Ci State Zi � n <br /> - Phone: 0 ax: <br /> CONTRACTOR: <br /> Coman : <br /> Name: <br /> Contractor's License #: `t E-Mail: <br /> Phone: — Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name:� � � ' � Firm Name: `� � ' <br /> Address: d i Ci : tate: � ( Zi : <br /> State License #: Phone: j- �(.(,��'3�ell: �— Fax: �, "� - U <br /> Descriotion of Project <br /> TYP OF DRNEWAY �,LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRNEWAY �_WIDTH OF DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> CONSTRUCTION MATEREAL CURB CUT RE UIRED ( )OTHER(EXPLAIN) <br /> ASPHALT YES NO <br /> �CONCREfE <br /> HEADWALL REOUIRED? YES �NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings <br /> will be required. � <br /> UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />