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u <br /> � <br /> ,• , <br /> . �.� <br /> :w� �, <br /> PERMIT APPLICATION u�� �""�• ✓ <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <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 /> � - = - _ _ :� _ _ - - °.,-r �r;� - „� _ � <br /> � ::� .� �Processed;B .;Permit.#:;:_."` <br /> ,. . . ._. .. . .... r_: . . <br /> ,Date:,of�appli�tiont�;.�: � y:.;;;;;. _ . ;��:.,;; �.s�� <br /> 4�. - -9�%�i� .�,: _ f��='� _ - :'���.�' iwi <br /> �', , - -- -=`s:i,. `(gray ara5 :sta� o;,iy).� - -- �,�>� _ - - <br /> -- = - - � - -_ -- .- - -- .a: �'��.�: — _ - _°' - �v <br /> - = - - ' �1;:�:` - - <br /> - - �0 _tO��IJb�1CWOf�(S`' - <br /> ^CO '��t0'B(11{dIR�"DE�BftrTI�P_flt�- - �r�' •��t. - - <br /> . ,. .,_ <br /> . : .,-.�t :. _ <br /> ,_ <br /> �y <br /> �. . . �;�: ..:❑ <br /> . - <br /> . -. <br /> � <br /> - . ...., � , � <br /> . � �•� Py .- . -.9...P_.. ___, .' �.P_�, <br /> PRO CT/ OB E• PR P RTY OWNER <br /> Address: �� Name: <br /> Unit#: Address: U'I �t Unit: <br /> Parcel Identification Number: - - - - Ci State Zi <br /> Phone: - ((� Fax: <br /> CONTRACTOR: <br /> Com an : " <br /> Name: <br /> Contract r's License #: � �(, E-Mail: , .[�.( <br /> Phone: � - ( Cell: — Fax: - � <br /> ARCHITECT/ENGINEER: <br /> Name: � L , Firm Name: {��"IL �[�n <br /> Address: , Ci : State: i : <br /> State License#: Phone: ' - ell: �-�'" Fax: 7 • a� <br /> � <br /> Description of Project <br /> t <br /> TYPE OF DRIVEWAY �1 LENGTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRNEWAY �WIDTH OF DRNEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRNEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> ( )OTHER(IXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT RE UI ED <br /> ASPHALT YES NO <br /> ,�CONCREI'E <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 />