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.,,:< � <br /> PERMIT APPLICATIQN "� '$'�'�"-`` <br /> DR3VEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All informa6on must be fi3led-in campletely <br /> City of Zephyrhills <br /> 5335 8�'Street,Zephyrhills,Ft.33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> �Date'ofappli�tione•/(>�f - - '_Proces"sed`By: � �Q-g�,=.- - _ ;'PerniiE�f.�� . - ,. - --- _ . <br /> � '-"e• ;�.- � .. .. ' . -c..''�, � ��{9!aya�tarsffi!` ordy.}.. . ' ,_„ - .'r';- .. _ <br /> � <br /> ` x ' ' ; _ " <br /> . . . �. ...,,. ,�.. -. . ., . , . . <br /> t�,:_.. .._,� - ::_, , ,� �,-� . <br /> , , <br /> :._�:,�. ..�'.� :'��PY�Btilding Deparbnent-:.� :;; .�,- ,"+ ,' (�opy to PutiGc tNork`s, <br /> PRQ] CT ]OB ITE: PROP Ft flWlVER <br /> Acidress: � Name: <br /> Unit#: Address: 't: � <br /> Parcel Identi ication Number: � Ci Stat Zi ^ <br /> -,_ Phone� - {(� Fax• - �- <br /> COMTRACTOR: <br /> Com arr : <br /> Name: <br /> Contractor's License#: E-Mail; , , "� � ,GI`� <br /> Pho�e: -'7 (} Ceii: m--�� Fax: -`j <br /> AFtCHITECT/ENGINEER: <br /> ' 't' l �vL <br /> Name: � r�"f Firm Name: <br /> Address: ti y d Ci : Q' State: l Zi : <br /> State License#: � Phone: -V:��[ -�t3� e11: -- Fax: �-- <br /> Description af Proiect <br /> TYPE OF DRNEWAY LENGTH OF DRIVEWAY CUlVERTS NEEDED <br /> ,RESIDENTIAE DRNEYVAY WZDTN OF DRIVEWAY ( }REINFORCED CONCRECE <br /> COMMERCIAL DRNEWAY R.O.W. EXCAVATION O CORRUGATED MATERTAL <br /> _PUBLIC ACCE55 DRIVEWAY �DEPTH ^LINEAR FEET ( )BOX CULVERT <br /> CONSTRUG7IOtti MATERIAt CURB CUT REOUIRED � a a�ER{IXPLAIN) <br /> ASPHALT ' YES �NO <br /> ��CONCRETE <br /> HEADWALL REOUIREp? YES �NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permiks or drawings <br /> will be required. <br /> UTILITY LOCATIONS REQUIRED: CALL SEFORE YOU DIG:1.$00.432.4770 <br /> Page 1 of 3 <br /> � <br /> I <br />