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d �.c�c��� <br /> *:,,y��`iZ.kr:., <br /> .�>✓ `t,�'rV: <br /> PERMIT APPLICATION ��� `�'°h �` <br /> �,�;'.:� <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 />� Date of application: , , . 'P.rocessed By:: :. � � � . Permi##:, . . " - , <br /> ` � , ' (9ray area for smff use bnly) • = ` , , <br /> ���Copyto Building Department � � ` .�Gopy'to Public:Works ` � <br /> PRO7ECT/70B SITE: PROPERTY OWNER <br /> i , .. <br /> Address: " r Nam : <br /> C� (C e '' (1 1 �5 C � <br /> Unit #: <br /> Address: � I Unit: <br /> Parcel Identification Number: -z(�- 2.1-003b� v0 0 Ci State Zi " ( L 5 � <br />� � Phone: "� Fax: <br /> CONTRACTOR: <br /> Com an : �p <br /> Name: � S <br /> Contractor's License #: �� Q 35`� E-Mail: �Y- c aQ 6 (� Q .(� <br /> Phone: 1��5-�1� Cell: $} �3 R�55 Fax: " <br /> ARCHITECT/ENGINEER: <br /> , <br /> Name: p�l f(t �( ( Firm Name: }'T � �� j� � (�(� I'1 <br /> Address: DO VYl Vl Ci : 1r 1'C� State: L Zi : q"lo <br /> State License #: � Phone: 81 (p(o�. 81 Cell: $l (o �{ Fax: <br /> T�'1PX�i IS Ctfl Description of Project �� <br /> � �.X 1 S�Y� � <br /> TYP F DRNEWAY `, LENGTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRNEWAY ��)��W�7 WIDTH OF DRNEWAY ( )REINFORCED CONCREfE <br /> COMMERCIAL DRNEWAY G�6'1� R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRNEWAY �;O r�� DEPTH LINEAR FEEf ( )BOX CULVERT <br /> � ( )OTHER(IXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED <br /> ASPHALT YES NO <br /> ��CONCREfE <br /> HEADWALL REQUIRED? 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 REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />