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PERMIT APPLICATION <br /> t.. <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 <br /> Dafbe of.aippli ' <br /> cation:' Y ProceSsed:Bye : Permit# <br /> - - - _ t9rar aim foi,staff Ilse only}, _ <br /> t,.: <br /> C a:PiiblicW(3Gopy:to Hold"ing.Depart?fient:,t'.',..`,'' opY_.... . or9cs D <br /> PROJECT JOB SITE: PROPERTY OWNER <br /> Address: 39421 South Avenue Ze h rhills, FL Name: US GOVERNMENT <br /> Unit#: Address: General Services Adm . .Unit: <br /> Parcel Identification Number:07-26-22-0000-00300-0010 City_, State Zip Washington, DC 20405-0001 <br /> ! Phone: N/A Fax: N/A <br /> CONTRACTOR: <br /> To Be Determined Through Public Bid Process <br /> Company: —_.....__..._ <br /> Name: <br /> Contractor's License #:. E-Mail: <br /> Phone: Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Udeni T.,Rosario Firm Name: Jones Edmunds&Associates, Inc. <br /> Address: 730 NE Waldo Road City: Gainesville State: FL Zip: 32641 <br /> State License #: 68327 Phone: 352-377-5821 Cell: Fax: 352-377-3166 <br /> Description of Proiect Refer to attached Drawings. <br /> TYPE OF DRIVEWAY 55 feet LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY 12 feet WIDTH OF DRIVEWAY (X)REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> X PUBLIC ACCESS DRIVEWAY 36 inchesDEPTH 55 feet LINEAR FEET ( }BOX CULVERT <br /> (Approximate depth including culvert) ( }OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED <br /> --X—ASPHALT YES X NO <br /> CONCRETE <br /> HEADWALL REOUIRED? YES _X_No <br /> d <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 /> i <br /> Page I, of 3 <br /> ,i <br />