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� <br /> .Y�°���a�,�. <br /> A���.�,p.�.� "'i;�, <br /> PERMIT APPLICATION `"`�'��� �� <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> • City of Zephyrhills ! <br /> 5335 8"'Street, Zephyrhills, FL 33542 � <br /> Telephone 813.780.0000 Fax 813.780.0005 f <br /> 3Date of appiicafiion: ' ° - ; Prucessed By: � , Permit#: . - � <br /> i ' ' � � (9way areai far staff use on[y} , - $ <br /> �Copy to Building Departmec�t ` �- [�Copy fo Pubtic iNorks - � � <br /> PRO7ECT 70B SITE: PROPERTY OWNER <br /> Address: 5308 19th St Ze h rhills FL 33542 Name: Cecilia Coleman <br /> Unit#: Address: Unit: <br /> Parcel Identification Number: Ci State Zi Ze h rhills FL 33542 � <br /> Phone: 727 389-2314 Fax: <br /> I <br /> CONTRACTOR: I <br /> Company: A 8�A Development. Inc. � <br /> Name: Arthur Richard_Carroll. Jr. ; <br /> Contractor's License #: CGC1519991 E-Mail: ac(a)tampaflcontractor.com � <br /> Phone: (813)622-8886 Cell: Fax: ! <br /> I <br /> ARCHITECT/ENGINEER: I <br /> Name: Firm Name: i <br /> Address: City: State: Zip: i <br /> State License #: Phone: Cell: Fax: � <br /> � <br /> Description of Proiect ; <br /> I <br /> TYPE OF DRIVEWAY 57'-5"LENGTH OF DRIVEWAY CULVERTS NEEDED I <br /> �RESIDENTIAL DRIVEWAY 16,_10„WIDTH OF DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRNEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRNEWAY DEPTH LINEAR FEEf ( )BOX CULVERT <br /> ( )OTHER(IXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED <br /> ASPHALT YES �NO <br /> �CONCREfE <br /> HEADWALL REOUIRED? YES X NO <br /> � <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings i <br /> will be required. I <br /> UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 ; <br /> I <br /> i <br /> Page 1 of 3 � <br /> I <br /> I <br /> � <br /> � <br />