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�``<"_�'�.. <br /> ,r.,s.�n' - <br /> _,;n .cxn�.�= :j;a_ <br /> PERMIT APPLICATION `� -��""a - � <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhilis <br /> 5335 8th Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> � <br /> ;Date-of app6cation ,�-3b--J'�/ � Processed:By , �`�- -_Perm�t.# ..r"�$�- ,- ' - ,� ,, <br /> �:-_ .. �<- ;. ._� ... (grayareaforstaffuseonly) - , _ _ - � " ' -i <br /> ; �: � , =❑Copy to Bwlding.Departinent = �opy to Public Works ���=f���ElP� <br /> PRO]ECT/JOB SITE: PROPERTY OWNER <br /> Address: �(�2 `� Name: rp <br /> Unit #: Address: Unit: <br /> Parcel Identification Number: Ci State Zi <br /> Phone: Fax: <br /> CONTRACTOR: <br /> � <br /> Company: EC'�►S �c�vlru.� U�NSTY7>CTI <br /> Name: L <br />' Contractor's License #: E-MaiL• �'-1►'�C•t3UW� <br /> Phone: 13- �0 Cell: � - ( Fax: (�- S <br /> ARCHITECT/EWGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Description of Project <br /> TYP OF DRIVEWAY _L LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY � WIDTH OF DRIVEWAY ( )RQNFORCED CONCRETE <br /> COMMERCIAL DRNEWAY .R O•W• EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LiNEAR FEET ( )BOX CULVERT <br /> - ( )OTHER(IXPLAIN) <br /> CONST UCTION MATERIAL CURB CUT REOUIRED <br /> SPHALT YES NO <br /> CONCREfE <br /> HEADWALL REOUIRED? YES NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this descrip�on,additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 , <br /> Page 1 of 3 <br />