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� .__ � <br /> � <br /> _ ;-; <br /> .._n�"�'"� �; <br /> 'rf� <br /> PERMIT APPLICATIOM ��` "��'�== � <br /> DRIVEWAY PERMIT APPLICATION <br /> . CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhills , <br /> ' S335 8"'Street,Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> ,. .�,...._ �... , . _ . _ <br /> ,Date=of:appli,catioii: `��.1 -- = ,;Processed'� �`� ; - - =Perinit_#=_ - = - , _ - - - . <br /> !:= - `- _ -- - - - � -- . - `',`- -_ <br /> - - - :,� � �v) - - -- _ _ <br /> i` '�N:` - .i`to"Buildm�i�P„aitmen['` - '` _ - - = �f <br /> - - ��PY. __ 9 ..eP _ _ / -- py to-Public:VVork4:' - - - - <br /> PRO]ECT/]OB ITE: PROP,ERTY OWNER <br /> Address• � '� Name• <br /> Unit#: Address: I(.rIC(� Unit: d <br /> Parcel Identification Number: - ;�- - �� Ci State Zi <br /> Phone: -" � -�� Fax: ' a-1, L � <br /> CONTRACTOR: <br /> Com an : � <br /> Name: <br /> Contra o 's License#: E-Mail: � `� <br /> Phone: Cell: '— Fax: - •� <br /> ARCHITECT/ENGINEER: <br /> Name: r �,� ' L "�. Firiti Name: ^ � L ' <br /> Address• `�� I Ci State: Zi � <br /> State License#: hone:` ' � ell: Fax: -1 p <br /> � � <br /> Description of Proiect " <br /> i <br /> TYPE OF DRIVEWAY �LENGTH OF DRNEWAY CULVERTS NEEDED <br /> _�RESIDENTIAL DRIVEWAY WIDTH OF DRNEWAY ( )RQNFORCED CONCREfE <br /> COMMERCIAL DRNEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> C TRUCTION MATERIAL CURB CUT RE UI D O OTHER(DCPLAIN), <br /> ASPHALT YES [}VO � <br /> _CONCRETE <br /> HEADWALL REOUIRED? YES X�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 />