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<br /> �DRIVEWAY:P.ERMYY:AP.PLICATION '
<br /> �CONSTRU.CTION�WITHTN:P.UBL:IC-RIGHT OF=WAY
<br /> i411 information must be-filled-in completely
<br /> :City.of�Zephyrhilis
<br /> "5335�8�'Street,Zephyrhills,.'FL 33542
<br /> ` Telephone.813.780.000 Fa 813J80.0005 �
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<br /> ':PRO]ECT .7 B:SITE: �PROPERTY'OWNER
<br /> Address: 2Z 2 �1. Name: 'R. � �t' - �
<br /> Uni�#: � Address• 2 �� S Unit: !
<br /> Parcel Identification Number: / — -�1��� O'� Ci .State .Zi � S �- �
<br /> � ��Z� Phone• !�-q9 Fax: ' '
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<br /> � IINTRACTOR:
<br /> Com an : �
<br /> Name• �
<br /> Contractor's LiceA e#: E-Mail: :
<br /> Phone• ` Cell: Fax: �
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<br /> A ��CHITECT/ENGINEER: , �
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<br /> Name: Firm Name:
<br /> Adciress• City: State: Zip:
<br /> Sta'te License#: Phone: Cell: Fax:
<br /> I Descriution of Proiect
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<br /> TYP F DRIVEWAY -/� LENGTH OFDRNEWAY CULVERTS NEEDED
<br /> II RESIDENTIAL DRI1/EWAY �WID7N OF DRIVEWAY ( )REINFORCED CONCRETE
<br /> I�COMMERQAI.DRNEWAY R.O.W. p(CAVATION O CORRUGATED MATERIAL �
<br /> I;PUBLIC ACCESS DRNEWAY DEPTH LINEAR FEEf ( )BOX CULVERT �
<br /> � ( )OTHER(IXPLAIN) I
<br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED �
<br /> � II,�PHALT YES NO
<br /> r/CONCREfE _
<br /> �
<br /> HEAIDWALL REOUIRED? YES NO �
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<br /> NOTICE TO APPLICANT: If actual work exceeds scope of this descriptiore,additional permits or drawings
<br /> �will�be required.
<br /> UTlLETY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770
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