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,,. <br /> f <br /> `"r. <br /> a <br /> PERMIT A�PLICATION t�* � <br /> �� <br /> DRIVEWAY PERMIT �4PPLICATICIN <br /> CQNSYRUCTIUN WITFlIN PUBLIC RIGHT-OF-V�PAY <br /> All information must be filled-in completely <br /> City of Zephyrhills <br /> 5335 8th Street,Zephyrhills, FL 33542 <br /> Telephone 813.78Q.0000 Fax 813.78QA005 <br /> FDate of applicatian:` yi' �, Rro:cesse'c1,B.y:,,�i �^� � . Permit#c , . '- , - <br /> , y , - (gray area-for.stafF� �on1y} ' ,. � <br />', �, Q[opy tc�Buildiitg Depattme�at;, • ',`Gopy�to.Bublic Wortcs � ' _. . , • , <br /> �_ <br />'�, O ECT/JOB SIT : PROPERTY OWNER <br />� Address: °` " Name: <br />, Unit#: Address: . Unit: <br /> Parcel Identification Number: a Ci Stat Zi <br /> - (_,1 Phone: -`�IU x: -�l,Q - <br /> CUNTRACTOR: <br /> Com an : � <br /> j Name: � <br /> II Contracto 's icense #: ' E-Mail: a ( _ �� � �� <br /> Phane: Cell: Fax: <br /> ARCHITECT j ENGINEER: <br /> IVame: t ���' Firm N me: Cl. ' �C, � � � <br /> Address: Ci State: Zi <br /> State License#: Phone: � - Cell: �-�" Fax: < " "7� ��(} <br /> �� <br /> Descriatian af Praiecfi <br /> TYP UF DRIYEWAY �LEIVGTN OF DRIVEWAY CUCVERTS NEEDED <br /> ��ESIDENTIAL DRIVEWAY ��WIDTH OF DRIVEWAY O REINFORCED CONCRETE <br /> COMMERCIAL Df2TVEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PiJB�IC ACCE55 DRIVEWAY DEPTH i.INEAR FEET { )B4X CULVERT <br /> ( )OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT RE_QU�RED <br /> ASPHALT YES �NO <br /> �CONCREI'E <br /> HEADWALL R�UIRED? YES �NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additianal permits or drawings <br /> wilt be required. <br /> UTILITY LOCATIONS REQIIIREQ: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Aageiof3 <br />