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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 8th Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> Date of:application: Processed By: Permit 4: I <br /> (gray,area,;f,'orstaff use only), <br /> ❑Copy io" ullding'Department ❑Copy to Public Works. <br /> PROJECT/JOB SITE: PROPERTY OWNER <br /> Address: S PK G Name: o, 40h- <br /> Unit #: Address:,00la•j.3 _D- Unit: <br /> Parcel Identification Number: City, State Zip �e s� <br /> /2-Ze?_/-Oz?2 - r6X; aD/2 Phone:A1_,> 99Z afiVe Fax: <br /> CONTRACTOR: <br /> Company: ca1T>.o, A^ec t.CC <br /> Name: ...Ql 05 , ../ <br /> Contractor's License #: E-Mail: <br /> Phone: Cell: / /�"6z:;, Fax: <br /> ARCH ITECT/ENG I NEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip. <br /> State License #: Phone: Cell: Fax: <br /> Description of Project <br /> TYPE OF DRIVEWAY 3s'`o LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY /WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( ) BOX CULVERT <br /> ( ) OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED iri0 <br /> ASPHALT YES .�29 NO <br /> CONCRETE <br /> HEADWALL REQUIRED? YES -"5' NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description, 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 />