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PERMIT APPLICATION <br /> DRIVEWAY PERMIT APPLICATIO14 <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OFW�WAY <br /> All Information MIgA be filled-in completely <br /> City of Zephyrhills <br /> 5335 am Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax$13.780.0005 <br /> �te:i�f�ppilcatlr' ��_ ' �reree��t��•8yt � ��.� " '•15: . . . .I�ermlt"#: . ., <br /> Ccrsr.na sorsun m�i�ih9 <br /> _ ;ft opy,taBul{�ing'U�p?rim�nt l a Y W PUM.Wvrji . 5- <br /> 'PROJECT/JOB � <br /> SITE: PROPERTY-OWNER <br /> Address: UC, _Name: <br /> Unit : Address: o•fJcrr s', x- Unit: <br /> Parcel Identification Number:/= �2/voiv-ros�r�o�i Glt State,Zip 2e iAie <br /> Phone: P/ " 99.E p . d Fax: <br /> CONTRACTOR: - <br /> Company: e - <br /> Name; <br /> Contractor's Ucense #: C �cos.�z; 6 _E-Mail: z5;K.-.vp ...5 y .�_ ,f:�w� i2;co•� <br /> Phone: Cell: P13 9/32Pgp Fax. — - <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: _ <br /> Address: Cityl State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Descrintlon_of EMIg t <br /> �IbRIVEWAY -P �:i1�.VMn LENGTH OF DRIVEWAY NEEDAD <br /> IDENTIAL DRIVEWAY &I'LWIDTN OF DRIVEWAY { }REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.Q.W. EXCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH !!NEAR FEET [ }BOX CULVERT <br /> CONSTRUCTION MATERIAL CURB CUB'REQUIRED ( )OTHER(EXPLAIN) <br /> _ASPHALT YES ,�ENO <br /> }-CONCRETE <br /> HFAUNALL RLQUIRED? YES NO <br /> NOTICE T APELIGANT.- If actual work exceeds scope of this description, additional permits or drawings <br /> will be required. <br /> UTILf3jLQQUIONSREQWBf& CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />