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- �,��n. <br /> ,,c,�-� I <br /> .-�� 0.� ����r��l"s9� 7���` <br /> , t � ` � <br /> �,� �,^,��;, <br /> PERMIT APPLICATION :�``-:=i�` <br /> 1 :� <br /> DRIVEINAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT—OF—WAY <br /> All information must be filled-in completety <br /> City of Zephyrhills <br /> 5335 8"'Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> �Date of.a licaition: �' ` -- . -Processed°B . �,i.- - "'�; a.:. ' ."_- Permit`.#: 8 - -_.; <br /> ; PP. ; _:tc�_ � .���� � y _ v � .��2 '= ,' � <br /> _ - -_ � �(gray area for.staff u �IY) _ ., ` /,�' s : <br /> f� � . ��s - - • . .. . . <br /> . ;�Copy to Bwldmg`Departrnent - - � ' `.�opY to�Pub(iclNorks `�--'Z`�_'� / � <br /> PRO]ECT/]OB SITE: PROPERTY OWNER <br /> Address:^ $' ,a � ��ol Lp Name: ,a� ST .o�.�-i fQ��J <br /> Unit#: Address: 3 SS�S /�°9e'�-��.�.,�-`Nnit: <br /> Parcel Identification Number: Ci State, Zi e 1,� a dI// L �7 sy�- <br /> Phone: Fax: <br /> �i3-�os/o�rs <br /> CONTRACTOR: <br /> Company: <br /> Name: T <br /> Contractor's License #: E-Mail: <br /> Phone: Cell: Fax: <br /> ARCHITECT/ENGINEER: , <br /> Name: Firm Name: li <br /> Address: City: State: Zip: I <br /> State License#: Phone: Cell: Fax: �� <br /> Descript�on of Pro�ect <br /> TYPE OF DRIVEWAY / LENGfH OF DRNEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRNEWAY �WIDTH OF DRNEWAY ( )RQNFORCED CONCREfE <br /> COMMERCIAL DRNEWAY R.O.W. EXCAVATION O CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> ( )OTHER(EXPLAIN) <br /> CONSTRUCTiON MATERIAL CURB CUT REOUIRED <br /> ASPHALT YES NO <br /> '�C CONCREfE <br /> HEADWALL REQUIRED? YES NO <br /> NOTICE TO APP�ICANT: 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 /> '� <br /> Page 1 of 3 \ <br />