Laserfiche WebLink
PERMIT APPLICATION <br /> IN <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhilis <br /> 5335 e Street,Zephyrhills, FL 33542 <br /> Telephone 813.786.0000 Fax 813.780.0005 <br /> '_4 <br /> -Kit7iffie'rm V Sao WC <br /> ffi:L17 r ff"A E Rpry M'p FRIKe MOR-1 <br /> C'�p ., 1C <br /> Co togui al q 11) tmeqW, 77 w <br /> Ar I <br /> p <br /> PROIECTIJOB SITE: PROPERTY OWNER <br /> Address: 501(o 18-1W-STe'F7 Name: vC/ <br /> Unit#: Address:3/325 Ambe,--JtA_ /?4n!t: <br /> Parcel Identification Number: City, State,Zip0aden Q ,rL_ _33S23 <br /> 1!-2 to-7-) -0010-2 1506 01-76 1 Phone:'2i3-'?73-52S0 F& <br /> CONTRACTOR: <br /> company: L3 tA Y c,, i nvc_)-J,, <br /> Name:—re-,, <br /> Contractor's License #: c R C /_?_q 2-114-115 E-Mail-&-jp4e..- vedei e.-Vj 0? <br /> Phone:V3473-5250 Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address- City: State: Zip:. <br /> State License #: Phone: C611: Fax: <br /> Description of Pr6iect <br /> TYPE OF DRIVEWAY LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> `_RESIDENTIAL DRIVEWAY <br /> WGDTH OF DRIVEWAY REINFORCED CONCRETE <br /> -COMMERCIAL DRIVEWAY R.O.W. EXCAVATION O CORRUGATED MATERIAL <br /> -PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET BOX CULVERT <br /> OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED <br /> -----ASPHALT ---YES NO <br /> _k,,:::t_ ONcRErE <br /> HEADWALL REQUIRED? YES NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS RtOUIRED; CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />