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s �„ <br /> PGRII•�ZT�I►�LL\rn�i01'e '��'��, <br /> ��i'_' _ <br /> D�tIVE�lAY PERN�IT APPLYCATIOA! <br /> CO�ISTRUC7"IQt�! �IIITNILa! PUBLIC RIGhIT-OF��/�Y <br /> All informatlon�be filled-in campletely , <br /> City of Zephyrhills <br /> 5335 8'"Street,Zephyrhflls, FL 33542 � <br /> Telephone 813.780.0000 Fax 813.780.00U5 ' <br /> Date ofapPlkatlon:�-7��(7 Proc�sed Byd - -- Pe'mit#: � �� <br /> (crar r c� «ry? � <br /> - _ __ []Copy to Buflding'Department _ - - _ ����b��W� <br /> PRO7ECT.�pB SITE; I� _ PROPERTY OWNER <br /> Address:56�.7 2oT7! sT, - /GG5 FG Name:l.El. MH G.EeS Kd ' Ban/nJ/E_�', ' <br /> Unit�: � Address:9// . N1�Gy-aiP ,¢d Unit: � <br /> Parcel Identiflcation Num6er: _ � CI State ZI . .6aR��q 2G . (�/6oy�5f7�3 � ' <br /> ! <br /> /1�.Zla=1/.-Do/0-/(000�0080 Phone•3oq-�gG�86o1 Faz:,}/.q. <br /> CONTRACTOR: - _ , <br /> Com an :.��7CK .Co .S�RUCTio / �, - - - <br /> Name:W/GGI�s►? �. g - - _ . _ <br /> Contractor`s Ucertse#:.C�C �/FDl - - _ - E-Mall:. ABAeq� _.-a[J'7GOC' � . <br /> -_Phone: � 1;_ �/ -355/f 9 5- Fax: .,4. - <br /> ARCHITECT/ENGINEER: - <br /> Name: � �✓a� V��e� Firm Name• , <br /> naaress: C' : S�tet . - ;' <br /> Stafe license#: � - - Z� � <br /> _ _ - Phone: _ Cell: _ Fax• <br /> - - �e cr( tion of P 'e - - - - ' <br /> T'P -0F bRNEW 3rotaA�GfH OF DRNEWAY �A. �_ <br /> RESIDENI7Al.DRNEWqY �" � ULVERTS NEEDED - <br /> COMMERQAL DRNEWAY �—�DTFi OF DRIVEWAY ( EINFORCED � - . <br /> PUBLiC ACCE55 DRNEWAY � EXCAVA'fION <br /> DEPTH LWEA— R FpET" � ) ;. ED MA'fERIA� <br /> ( ` CULV <br /> CUF2B CUT RE UI '0��(IXPLAIN) i <br /> SPHALT � -� . � - <br /> CONCAETE - - <br /> Q��ADWALL REQUIRED? YES V MO , <br /> NOTI�E YO lnPPtICANT: If ac�tual�nrork exoeeds scope of this descript6on,additional pesmit�or cirawings <br /> wP�P be rec�a�6red. <br /> UTILITY LOCAYLOIVS REQUIRED• CALL BEFQRE YOU DIG; 1.800.432.4770 <br /> Page i�f 3 � II <br />