|
� 3
<br /> .bv9
<br /> e� -.
<br /> 1 +, ,
<br /> 3
<br /> e. �
<br /> �
<br /> ir ,
<br /> PEItMIT APPL��TIOW '�'{• ' r= .:
<br /> - .:{`.:
<br /> ' � D�RIVEUI�AY:PERMIT.AP.PL�ICAT:�ON
<br /> � _. �C�MSTRUCT.lON�WITMTN:PUBL[C�RIGFIT=.O.F=VI�AY
<br /> All Iriformation�be-filled-in completefy I
<br /> � :Cityof:Zephyrhills
<br /> '5335 S�'Street,Zephyrhflls,'FL 33542
<br /> Telephone.813.780.0000 Fax 813.780.0005
<br /> Y�N � _ '�: ;,�•`✓�. `'l.'"ij�_��'. �:Y� :t � :".�t'R'i��k� '-'^.��i;•�]-F:'I y ..4 ',.1.�5�.�:i�:��;�
<br /> ���t�� ..Y.. - — V� :5.....�"'�:.:n:{':'�,�il' - ,'l...i::.:'_.'• -:L:'::':^
<br /> , is.n.y�` ;d•,� :`;ix?t'az;T �`��".:Ui4a �.4� ;4 =��::'��::Y.;i,;�•>:'n" .i::;'�:.,y.
<br /> ..t�. ,v,iF '.�r, :t5.� - �r:... { ,F';:"�r�..f:X-.,. t.y�.c=,�'�� �iroe -r:,i...s:c,l.
<br /> �a•,�i i - - - ra:::�� .,,: �i'Sc' :}: :r.�.= _ �t�„r' =v,,;_,... :+i�^.e: - .y.._�......
<br /> - ti}�=`� - -- :'3�, �.115L .ri�ih:•,-.et.e:-,. Yr.'.::`.•r - ',�`A'r,n•':ri ..v
<br />� "d� �'e, - .f. _�"'`.':e.� '%t.-T.-.,: :�:+'.L.� ::i:'
<br /> - �:'t"., ��+�� -'.�.�-••,•"•"`*�^ - - •�- .w,...K=`:� .r
<br /> 41j���'::.4 r...��A ' T:L�: � - -- ..t;�
<br /> :l '''� ::}...'I:�'�i=.;,;�'� - %`I�'. _
<br /> 1 :L;� �I.' _ _ .R�.',=.:il::':�.'.� �'3•::•=':.,;.< :1
<br /> •!. :�f•.�s�:y�e�r:=�;.r.+;.e;�• _2":i:.':�:e r i}.•_
<br /> '��P;$Re'�ig'�t_ . .. Rb. �tmks,:.,, r�'
<br /> .� 10'�._"-
<br /> "PR07ECT JOB'SITE: •PROPERTY'OWWER
<br /> Address: . SDS ' Name: e �R e oI� t '.t _ �ir_
<br />, Unft#: � Address:� 0 2 Unit:
<br /> ParcelIdentificatton Number. C State ZI Z h ; 53
<br /> Phone• I -71 Fax:
<br /> i
<br /> �
<br /> ;CONTRACTOR: �
<br /> . �
<br /> • Com n : i� � ,� ' �. ;
<br /> Name:
<br /> Contractar's License#. C C 1 a. 7 � E-Mail: o ri 3 a ��. evv�'1 '
<br /> �Phone: �1.�F7ly-yJ�3 Cell: Fax: `
<br /> ARCHITECT/ENGINI�ER: �
<br /> � �
<br /> �
<br /> f
<br /> Name: Frm Name:
<br /> Address: Gty: State• Zip• �
<br /> a
<br /> State License#: Phone: CeIL• Fax: ;'.
<br /> . a
<br /> Y
<br /> f
<br /> a
<br /> �SC�p�Qfl��I'A�@`� €
<br /> �'� d9'� `LENGiH OF DRNEWAY CULVERTS'NE�DED
<br /> RESIDENTIAL DRNEWAY t�"WIpTH OF DRIVEWAY ( )REINFORCED CONCRETE �
<br /> CbMMERCiAL DRIVEWAY R'�.�. DCCAVATAOAI ( )CORRUGATED MATERIAL �
<br /> _PUBLIC ACCFSS DRIVEINAY y�DERiH LINEAR FEEC ( )BOX CULVERT r
<br /> ( )Ol}1ER(DCPLAIN�_ P
<br /> � CONSTRUCRARI MA1'ERIAL Ct9RB CUT REOUYRED �,
<br /> ____.�SPHALT YES .�•'�NO
<br /> --��hICREfE
<br /> trEADwa«t�outr�n7 vEs •�'`�No ,.
<br /> ;
<br /> . 5,
<br /> 5
<br /> NO'PI�E TO APPL4CAPIT: I�actual work e�toe�d�scop�of this de�riptlon,atlditional permits or dtawings �
<br /> wftt be required.
<br /> UTi�I�'Y LOCATIORJS REfZd9IRED: Ck1LL B�FORE YOU DIG: 1.800.432.4770 '
<br /> �
<br /> Page 1 of 3 �
<br /> a
<br /> • ---.- "._.' ' — - ---- �
<br /> %
<br /> P
<br /> k
<br />
|