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, <br /> ,� '' <br /> s'�'`�<u _�4� <br /> PERMYT APPLICATION �}�f <br /> � �� ��- A�4 <br /> �` �-c�-� <br /> DRI\/EWAY PERMIT APPLIC/ATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-VU�AY <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 /> i- - -- - - -- - . - - - _- _ - .- _ ' - - �c=- - - '�.�;=`: <br /> D�e.of:a� li� fioii. - - -p�� :g:�;-_...:; _: <br /> at ca - rocessed. 4, - Perniit;#c� ��u; <br /> _ pPLL_ _ _.,Y�; - - <br /> �., - - <br /> - - - - .:t <br /> - - - - area'foF staff use ani - <br /> � — - - �e- . - - <br /> - r - <br /> �t9@Y _Y);�' <br /> - - ' - - - - - - -- - - ; -- >;a <br /> - ---- - �C` `i�'in"'`�D- : -_- - - _ _ -_ - . _ - <br /> d,'�fii'Bu Id e yartineiif- Co� 1?W l�i f�1N.* <br /> '��fo ubl c ork5�`L - <br /> .�� ^`�r,I - -y� - <br /> �r� - - PY._ 9. P r.�. `.r�'i - <br /> � <br /> PY. <br /> PRO7 CT/]OB ITE: ROPER OWNER � <br /> Address: ,, i ` ' �' Name: f ` <br /> Unit#: Address: ; j Q "Unit: ( <br /> Parcel Id ntification Number: Ci State Zi <br /> Phone: - ax: <br /> CONTRACTOR: <br /> Com an : � <br /> Name: <br /> Contract r's L' eRse #: E-Mail:� (� � <br /> Phone: ;� - ' Cell: Fax: - <br /> ARCHITECT/ENGIIVEER: <br /> � <br /> {� � <br /> Name: I � Firm N me: � . �� � • <br /> Address: j 5 Ci n State: Zi <br /> State License #: , Phone: �� - I Cell: � Fax: — ^ (� <br /> Description of Project <br /> TYP�OF DRIVEWAY �I LENGTH OF DRNEWAY CULVERTS NEEDED <br /> , L�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 /> ( )OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT RE UIRED <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 LOCATYONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> I Page 1 of 3 <br />